Close
13th August 2024
A 36-year-old female is brought to A&E by her partner with a 24 hour history of headache, fevers, confusion and lethargy
A 36-year-old female is brought to A&E by her partner with a 24 hour history of headache, fevers, confusion and lethargy. On examination, the patient’s GCS is 13 (E3, V4, M6). There is evidence of photophobia and neck stiffness on the neurological exam. Her observations are as follows: HR 108 bpm, BP 92/54 mmHg, RR 20/min, oxygen saturations 99%, temperature 38.1 degrees Celsius.
Blood tests show:
| Hb 141 (115-160) | Neutrophils 8.2 (2-7) | Na+ 134 (135-145) | Urea 3.3 (2-7) |
| WBC 12.1 (4-11) | CRP 34 (<5) | K+ 3.8 (3.5-5) | Creatinine 65 (45-84) |
CT head is normal and lumbar puncture results are pending.
Empirical treatment for meningoencephalitis is started with ceftriaxone, aciclovir and dexamethasone. You discuss the case with the microbiology consultant who recommends adding microbial cover for listeria whilst awaiting the full results. The patient has no known drug allergies.
What medication should you prescribe?
Select the SINGLE most appropriate option from the list below. Select ONE option only.
Complete Guide to Clinical Genetics ST3 Application and Recruitment (2027)
Written by Medibuddy. Last updated: October 2026. Clinical Genetics is
Complete Guide to Clinical Radiology ST3 Application and Recruitment (2027)
Recruitment paused: NHS England is not running Clinical Radiology ST3+ recru
Complete Guide to Paediatric Surgery ST3 Application and Recruitment in United Kingdom (2026)
Written by Medibuddy. Last updated: October 2026. If you’re planning
Take your subscriptions with you
Our mobile app allows you to access your interview and exam question banks wherever you are.
