Question

A 45-year-old woman presents with sudden onset severe headache, neck stiffness, and photophobia. She is febrile and appears ill. CT scan of the head without contrast is normal. There is high suspicion for bacterial meningitis. What is the most appropriate next step in management?

Accepted Answer

Start empiric intravenous antibiotics and dexamethasone immediately, then perform lumbar puncture as soon as possible

Answer

Perform lumbar puncture immediately and start empiric intravenous antibiotics afterwards

Answer

Wait 6 hours for CT angiography before starting antibiotics

Answer

Treat with oral antibiotics as an outpatient

Answer

Observe without treatment because CT is normal

Practice question

A 45-year-old woman presents with sudden onset severe headache, neck stiffness, and photophobia. She is febrile and appears ill. CT scan of the head without contrast is normal. There is high suspicion for bacterial meningitis. What is the most appropriate next step in management?