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Meningococcal sepsis with meningitis — RCPSC EM MCQ

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HardNeurological emergenciesMeningococcal sepsis with meningitisRCPSC EM

A 57-year-old man has fever, headache, confusion, and purpuric rash. Blood pressure is 88/50 mmHg, neck stiffness is present, platelets are 62 x 10^9/L, and CT scanner access is delayed. What is the most appropriate next step?

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Correct answer: E — Immediate IV ceftriaxone, sepsis resuscitation, and droplet precautions

Suspected meningococcal sepsis/meningitis with shock requires immediate antibiotics and resuscitation. Lumbar puncture is unsafe with severe thrombocytopenia and should not delay treatment.

Reference: Association of Medical Microbiology and Infectious Disease Canada guidance; Surviving Sepsis Campaign