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Bacterial meningitis with raised ICP concern — RCPSC EM MCQ

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HardNeurological emergenciesBacterial meningitis with raised ICP concernRCPSC EM

A 56-year-old on rituximab presents with fever, confusion, and neck stiffness. BP is 102/58 mmHg, HR 118/min, and funduscopy suggests papilloedema. CT will be delayed by 45 minutes and blood cultures have been drawn. What is the most appropriate next step?

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Correct answer: A — Give empiric antibiotics and dexamethasone before CT

Give empiric antibiotics and dexamethasone before CT is correct: the clues indicate Bacterial meningitis with raised ICP concern and this option addresses the immediate ED priority. The distractors delay care, target a less likely problem, or are unsafe in this physiology.

Reference: Canadian meningitis emergency practice