A 65-year-old man with fever, confusion, neck stiffness and photophobia presents to the ED. Suspected bacterial meningitis is diagnosed clinically. CT...

Question

A 65-year-old man with fever, confusion, neck stiffness and photophobia presents to the ED. Suspected bacterial meningitis is diagnosed clinically. CT head is not immediately available but there are no focal neurological deficits. What is the most appropriate next step?

Accepted Answer

Give empiric intravenous antibiotics and dexamethasone immediately, then arrange LP

Answer

Wait for CT before starting antibiotics

Answer

Perform lumbar puncture and wait for CSF results before antibiotics

Answer

Order MRI brain first

Answer

Start oral antibiotics and arrange outpatient LP

ca-mccqe1 MCQ (SBA): Empiric treatment of suspected bacterial meningitis

A 65-year-old man with fever, confusion, neck stiffness and photophobia presents to the ED. Suspected bacterial meningitis is diagnosed clinically. CT head is not immediately available but there are no focal neurological deficits. What is the most appropriate next step?