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Suspected meningococcal meningitis with septic shock — SCE Acute Medicine MCQ

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ModerateNeurology and ophthalmologySuspected meningococcal meningitis with septic shockSCE Acute Medicine

A 19-year-old student presents with fever, confusion, photophobia and a non-blanching rash. Blood pressure is 92/50 mmHg, pulse 128/min and lactate is 4.2 mmol/L. CT head is not immediately available and there is no focal neurological deficit. What is the most appropriate next step in management?

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Correct answer: C — Give immediate intravenous ceftriaxone and take blood cultures without delaying treatment

Suspected meningococcal sepsis or bacterial meningitis with shock requires immediate intravenous antibiotics after blood cultures if this does not delay treatment. Lumbar puncture is deferred in unstable patients and should not delay antibiotics. Aciclovir may be added if encephalitis is suspected, but ceftriaxone is central here.

Reference: NICE NG240 bacterial meningitis and meningococcal disease