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Meningococcemia — RCPSC EM MCQ

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HardInfectious disease emergenciesMeningococcemiaRCPSC EM

CTAS 1: A 17-year-old has fever, myalgias and rapidly progressive confusion. Vitals are T 40.0°C, BP 78/42, HR 148. A non-blanching purpuric rash covers the legs. Platelets are 42, lactate is 7.4 mmol/L and INR is prolonged. What is the most likely diagnosis?

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Correct answer: C — Meningococcemia with septic shock

Fever, shock, purpura and DIC features are meningococcemia until proven otherwise. Droplet precautions, ceftriaxone and critical care resuscitation are urgent.

Reference: Canadian infectious disease practice; public health meningococcal guidance