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Acute bacterial meningitis — RCPSC IM MCQ

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ModerateInfectious DiseasesAcute bacterial meningitisRCPSC IM

A 71-year-old man presents with fever, confusion, neck stiffness and photophobia. Blood pressure is 138/82 mmHg. CT head is ordered because of altered mental status. Blood cultures are drawn immediately. There is no beta-lactam allergy. What is the most appropriate management?

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Correct answer: E — Give empiric ceftriaxone, vancomycin, ampicillin and dexamethasone without waiting for CT

Suspected bacterial meningitis requires immediate empiric therapy. In older adults, ampicillin adds Listeria coverage; dexamethasone is given early when pneumococcal meningitis is possible.

Reference: Canadian infectious diseases meningitis guidance