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Meningococcal sepsis — RCPSC EM MCQ

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ModerateInfectious disease emergenciesMeningococcal sepsisRCPSC EM

A 24-year-old man presents with fever, severe headache and non-blanching purpuric rash. Blood pressure is 84/48 mmHg and lactate is 6 mmol/L. He is confused, photophobic and has neck stiffness. What is the most appropriate initial management?

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Correct answer: A — Give empiric IV ceftriaxone immediately after blood cultures if this does not delay antibiotics

Suspected meningococcal sepsis or meningitis with shock needs immediate empiric antibiotics and sepsis resuscitation. Lumbar puncture is deferred when unstable.

Reference: Canadian meningitis guidance; Surviving Sepsis Campaign; CAEP sepsis resources