A 2-year-old child from a slum setting develops acute onset fever, headache, neck stiffness, and photophobia. CSF examination shows: turbid fluid, 1200 cells/mm3 (90% neutrophils), glucose 20 mg/dL (serum glucose 90 mg/dL), protein 250 mg/dL. CSF Gram stain shows Gram-negative diplococci. What is the DRUG OF CHOICE?
- A Vancomycin
- B Ampicillin
- C Ceftriaxone ✓
- D Chloramphenicol
Correct answer: C. Ceftriaxone
Explanation
Gram-negative diplococci in CSF indicate Neisseria meningitidis (meningococcal meningitis). The CSF profile with low glucose ratio (<0.4), high protein, and neutrophilic pleocytosis confirms bacterial meningitis. Ceftriaxone (a third-generation cephalosporin) is the drug of choice for bacterial meningitis in children beyond neonatal age, covering meningococcus, pneumococcus, and H. influenzae. Dexamethasone as adjunct therapy reduces neurological sequelae.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.