EM Cases · Meningitis and encephalitis
Meningitis and meningococcaemia — the deteriorating resus station
An ACEM Fellowship OSCE clinical-management (resus) station. Tests recognition of meningococcaemia, antibiotics-before-LP discipline, empiric regimen with dexamethasone, shock resuscitation, and public-health actions. ACEM-primary, globally tagged.
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Target exams
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Prompt
A febrile young adult with headache and a spreading purpuric rash who deteriorates into septic shock and reduced GCS.
Station brief
Format. Clinical-management (resus) station, 11 minutes total — 4 minutes reading, 7 minutes active assessment. You are the Emergency Medicine consultant leading the resuscitation.
Candidate instructions. You are handed over a 19-year-old university student. Read the observations and scenario, then manage the patient. The examiner will play the nursing team and respond to your instructions. State actions and reasoning aloud.[2]
References4ShowHide
- [2]National Institute for Health and Care Excellence. Meningitis (bacterial) and meningococcal disease: recognition, diagnosis and management NICE guideline NG240, 2024.Source
- [5]de Gans J, van de Beek D. Dexamethasone in adults with bacterial meningitis. New England Journal of Medicine, 2002.PMID 12432041
- [8]Auburtin M, Wolff M, Charpentier J, et al. Detrimental role of delayed antibiotic administration and penicillin-nonsusceptible strains in adult intensive care unit patients with pneumococcal meningitis. Critical Care Medicine, 2006.PMID 16915106
- [10]UK Health Security Agency. Guidance for public health management of meningococcal disease in the UK UKHSA, 2025.Source