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Bacterial meningitis — DCH MCQ

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HardPaediatric emergenciesBacterial meningitisDCH

A 7-year-old has fever, headache and neck pain. He is photophobic, vomited twice, has a positive Kernig sign and a heart rate of 145/min. What is the most appropriate management?

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Correct answer: E — Urgent hospital transfer for suspected meningitis

Meningeal symptoms with fever and systemic disturbance require urgent hospital assessment for possible meningitis. Migraine can cause photophobia and vomiting but would not explain fever, meningism and tachycardia. The pearl is that a rash is not required for meningitis to be serious.

Reference: NICE NG240