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Meningococcal sepsis (paediatric) — DIPIMC MCQ

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ModeratePaediatric and Obstetric EmergenciesMeningococcal sepsis (paediatric)DIPIMCDipIMC

A toddler has a high fever, lethargy and a non-blanching purpuric rash, with cool peripheries, tachycardia and a prolonged capillary refill time.

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

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Correct answer: E — Give intramuscular or intravenous benzylpenicillin, oxygen and an intravenous fluid bolus, and transfer urgently

Explanation lettering: E = shown as A · A = shown as E

A non-blanching rash with features of shock in a child suggests meningococcal sepsis, which is treated with urgent parenteral benzylpenicillin (or ceftriaxone), oxygen, fluids and rapid transfer. Delaying antibiotics for hospital cultures (D) costs time in a rapidly fatal disease. Suspected meningococcal sepsis is a true emergency: give parenteral antibiotics and move without waiting for investigations.

Reference: NICE NG51; JRCALC Clinical Guidelines