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Bacterial meningitis with sepsis — RCPSC EM MCQ

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ModerateNeurological emergenciesBacterial meningitis with sepsisRCPSC EM

CTAS 2: A 24-year-old has fever, severe headache, photophobia and confusion. Vitals are T 39.5°C, HR 124, BP 94/58. Neck stiffness is present and petechiae are seen on the legs. No focal deficit or papilloedema is found. What is the most appropriate initial management?

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Correct answer: D — Give ceftriaxone and vancomycin with dexamethasone after blood cultures

Suspected bacterial meningitis with sepsis needs immediate empiric antibiotics and dexamethasone after blood cultures if this does not delay therapy. LP follows when safe.

Reference: Canadian infectious disease practice; IDSA meningitis principles