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Bacterial meningitis — MCCQE Part 1 MCQ

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HardChild with FeverBacterial meningitisMCCQE Part 1

A 9-month-old infant presents with fever, lethargy and poor feeding. He has a bulging fontanelle and a non-blanching rash. Capillary refill is 4 seconds and heart rate is 178/min. What is the most appropriate next step in management?

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Correct answer: E — Give empiric intravenous antibiotics immediately after blood cultures if this does not delay treatment

This infant has signs of sepsis and meningitis; blood cultures should be obtained rapidly if feasible, but antibiotics must not be delayed. Lumbar puncture may be unsafe before stabilisation and should not postpone treatment. Outpatient management is inappropriate.

Reference: CPS meningitis resources; AMMI Canada guidance