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Meningococcal sepsis — DipIMC MCQ

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HardMedical EmergenciesMeningococcal sepsisDipIMC

A university student has fever, confusion, limb pain, a non-blanching purpuric rash and BP 86/52 mmHg. Emergency transfer is being arranged and intravenous access is immediately available. Which pre-hospital priority is most appropriate?

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Correct answer: A — Resuscitate, pre-alert and give ceftriaxone unless this delays transfer

The best answer is “Resuscitate, pre-alert and give ceftriaxone unless this delays transfer”. Strongly suspected meningococcal disease needs emergency transfer and senior pre-alert. NICE advises IV or IM ceftriaxone or benzylpenicillin as soon as possible outside hospital unless this delays transfer. Resuscitation continues in parallel. Cultures and lumbar puncture are hospital investigations; antipyretics or fluid alone do not address invasive meningococcal disease with shock.

Reference: NICE NG240, Meningitis (bacterial) and meningococcal disease: https://www.nice.org.uk/guidance/ng240/chapter/recommendations