A 10-year-old boy is brought to the emergency department because of high-grade fever and lethargy for 4 days. He has had a severe headache for 3 days and 2 episodes of non-bilious vomiting. He appears ill. His temperature is 40.1°C (104.2°F), pulse is 131/min, and blood pressure is 92/50 mm Hg. Examination shows nuchal rigidity. Kernig and Brudzinski signs are present. A lumbar puncture is performed. Analysis of the cerebrospinal fluid shows a decreased glucose concentration, increased protein concentration, and numerous segmented neutrophils; a Gram stain shows gram-negative cocci in pairs. The parents are concerned about their younger son, who shares a bedroom with the patient. Which of the following is the most appropriate management of this patient's household contacts?

Question

A 10-year-old boy is brought to the emergency department because of high-grade fever and lethargy for 4 days. He has had a severe headache for 3 days and 2 episodes of non-bilious vomiting. He appears ill. His temperature is 40.1°C (104.2°F), pulse is 131/min, and blood pressure is 92/50 mm Hg. Examination shows nuchal rigidity. Kernig and Brudzinski signs are present. A lumbar puncture is performed. Analysis of the cerebrospinal fluid shows a decreased glucose concentration, increased protein concentration, and numerous segmented neutrophils; a Gram stain shows gram-negative cocci in pairs. The parents are concerned about their younger son, who shares a bedroom with the patient.  Which of the following is the most appropriate management of this patient's household contacts?

Quizplus · Accepted Answer

Eductional Objective: Rifampin is the most frequently used agent for chemoprophylaxis of meningococcal disease.  Persons with exposure to the respiratory secretions of a patient with meningococcal disease require chemoprophylaxis.  Vaccination is an important public health strategy but is not useful for post-exposure prophylaxis.

A 10-Year-Old Boy Is Brought to the Emergency Department Because