A 19-year-old university student presents with sudden onset fever, severe headache, photophobia and neck stiffness. Temperature is 39.5°C, HR 120 beat...

Question

A 19-year-old university student presents with sudden onset fever, severe headache, photophobia and neck stiffness. Temperature is 39.5°C, HR 120 beats/min, BP 110/70 mm Hg. There are no focal neurological deficits. According to standard Canadian practice, what is the most appropriate next step?

Accepted Answer

Start empiric intravenous antibiotics immediately after obtaining blood cultures, then perform lumbar puncture when safe

Answer

Order CT brain and await results before any other action

Answer

Discharge with Gravol and oral analgesics only

Answer

Delay antibiotics until CSF Gram stain is available

Answer

Observe overnight without investigations

ca-mccqe1 MCQ (SBA): Acute bacterial meningitis

A 19-year-old university student presents with sudden onset fever, severe headache, photophobia and neck stiffness. Temperature is 39.5°C, HR 120 beats/min, BP 110/70 mm Hg. There are no focal neurological deficits. According to standard Canadian practice, what is the most appropriate next step?