Petechiae, Purpura, and Panic
This early skin finding in meningococcemia is often mistaken for a benign viral rash.
What is Petechiae?
In bacterial meningitis, CSF opening pressure is typically described as this.
What is elevated?
This antibiotic should be given immediately when meningococcemia is suspected.
What is IV Ceftriaxone?
The classic triad of DGI includes dermatitis, tenosynovitis, and this joint finding.
What is migratory polyarthritis?
Close contacts of meningococcemia patients should receive this medication.
What is Rifampin (or ciprofloxacin / ceftriaxone acceptable)?
Rapid progression to this ominous rash signals vascular thrombosis and skin necrosis.
What is Purpura fulminans?
This predominant cell type can be seen in the CSF of meningococcal meningitis.
What are neutrophils?
This ED intervention saves lives before cultures come back.
The rash of DGI is classically described as these types of lesions.
What are pustular or vesiculopustular lesions?
Gonorrhea is reportable because of this major public health concern.
What is antibiotic resistance?
This triad may be seen in severe meningococcemia: hypotension, DIC, and this adrenal catastrophe.
What is Waterhouse-Friderichsen syndrome?
CSF glucose levels in bacterial meningitis are best described as this relative to serum glucose.
What is low?
You should never delay antibiotics in order to perform this diagnostic test.
What is an LP?
Blood cultures are often negative, but this site is more likely to yield N. gonorrhoeae.
What is synovial fluid?
This group must receive chemoprophylaxis even if asymptomatic after exposure.
What are household or intimate contacts?
This life-threatening complication explains why patients can lose limbs within hours.
What is DIC?
Depending on the presentation, may want to order this test before performing your LP.
What is a CT brain without IV contrast?
This vasopressor is first-line for septic shock in meningococcemia.
What is norepinephrine?
This population is at increased risk for disseminated gonococcal infection.
What are menstruating or pregnant women?
This ED exposure qualifies for meningococcal chemoprophylaxis.
What is direct contact with respiratory secretions (e.g., intubation, suctioning)?
A rapidly progressive purpuric rash plus hypotension should trigger concern for this diagnosis even without meningitis.
What is Meningococcemia?
A patient with suspected meningococcal meningitis receives ceftriaxone prior to lumbar puncture. This CSF finding is most likely to remain abnormal.
What is protein level? (will remain elevated)
This adjunctive therapy may be given early in suspected meningitis to reduce neurologic sequelae.
What is Dexamethasone?
Unlike meningococcemia, DGI is rarely associated with this life-threatening condition.
What is septic shock?
This condition should be suspected in any patient with recurrent meningococcal infections.
What is complement deficiency?