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Acute bacterial meningitis — ABEM Board MCQ

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ModerateInfectious disease emergenciesAcute bacterial meningitisABEM Board

A 42-year-old man presents as triage level 2 with fever, headache, photophobia, neck stiffness, and petechial rash. BP is 104/62 mm Hg, and CT is not required before lumbar puncture based on exam. Which of the following is the most appropriate initial action?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Draw blood cultures, give ceftriaxone and vancomycin promptly, then perform lumbar puncture

Suspected bacterial meningitis requires immediate empiric antibiotics after blood cultures; LP should not delay treatment.

Reference: IDSA bacterial meningitis guidance; CDC meningococcal guidance