A 24-year-old university student presents with fever, headache, vomiting and a non-blanching purpuric rash. BP 86/50, HR 140, GCS 13, lactate 4.8

Question

A 24-year-old university student presents with fever, headache, vomiting and a non-blanching purpuric rash. BP 86/50, HR 140, GCS 13, lactate 4.8 mmol/L. What is the most appropriate initial management?

Accepted Answer

Immediate ceftriaxone, sepsis resuscitation, droplet precautions and public health notification

Answer

Oral azithromycin and discharge with rash precautions

Answer

Observation until blood cultures are positive

Answer

Lumbar puncture before antibiotics despite shock

Answer

Topical steroids and antihistamines

Meningococcemia — RCPSC EM MCQ

A 24-year-old university student presents with fever, headache, vomiting and a non-blanching purpuric rash. BP 86/50, HR 140, GCS 13, lactate 4.8 mmol/L. What is the most appropriate initial management?