A 19-year-old previously healthy woman presents with sudden onset fever (39.8°C), severe headache, and petechial rash. Vital signs show BP 98/62, HR 118, RR 22, SpO2 98% on room air. CSF analysis reveals elevated protein (180 mg/dL) and low glucose (28 mg/dL). Blood cultures cannot be obtained before antibiotics due to rapid clinical deterioration. She denies recent antibiotic use. Which antimicrobial regimen is most appropriate for presumed meningococcal meningitis?
- A)Ceftriaxone plus vancomycin plus ampicillin
- B)Vancomycin monotherapy due to emerging cephalosporin resistance
- C)Penicillin G monotherapy as first-line treatment
- D)Fluoroquinolone plus cephalosporin for synergy against Neisseria
- E)Ceftriaxone alone covers all likely pathogens adequatelyGABARITO
Explicação
In a previously healthy 19-year-old with meningococcal meningitis (classic presentation with fever and petechiae), Neisseria meningitidis is the likely pathogen. High-dose IV ceftriaxone provides excellent CSF penetration and covers N. meningitidis with reliab... Ver explicação completa e trilha adaptativa →