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Suspected bacterial meningitis — SCE Acute Medicine MCQ

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HardInfectious diseasesSuspected bacterial meningitisSCE Acute Medicine

A 37-year-old woman presents with severe headache, fever and photophobia. She is confused, temperature is 39.1°C and has neck stiffness. CT head is delayed because the scanner is occupied, and there are no focal neurological signs or papilloedema. Blood cultures have been taken. What is the most appropriate next step in management?

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Correct answer: D — Give empirical intravenous ceftriaxone immediately and do not wait for CT

Suspected bacterial meningitis is time-critical, and antibiotics should not be delayed for CT when imaging is not immediately available and there are no clear indications mandating CT before LP. Ceftriaxone is appropriate empirical therapy in most adults, with adjuncts such as dexamethasone according to local policy. LP remains important but should follow immediate treatment if it would delay antibiotics.

Reference: NICE NG240