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Meningococcal disease — RACP Paediatrics MCQ

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HardInfectious diseases and immunisationMeningococcal diseaseRACP Paediatrics

A 4-year-old has fever, leg pain and a rapidly spreading non-blanching purpuric rash. He is drowsy, capillary refill is 5 seconds and blood pressure is low for age. What is the most appropriate management?

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Correct answer: B — Give immediate parenteral ceftriaxone and manage septic shock

Purpuric rash with shock is meningococcal sepsis until proven otherwise and requires immediate parenteral antibiotics and resuscitation. Absence of meningism does not exclude invasive meningococcal disease. Time to antibiotic administration and shock management are critical determinants of outcome.

Reference: RCH Acute meningococcal disease guideline; Therapeutic Guidelines (eTG)