Child with generalized petechiae. CSF shows gram negative diplococci. Treatment –
**Core Concept**
The question is testing the identification and management of a specific bacterial infection causing petechiae and meningitis. The presence of gram-negative diplococci in the cerebrospinal fluid (CSF) is a key diagnostic clue. This organism is a common cause of meningitis, particularly in infants and young children.
**Why the Correct Answer is Right**
The correct answer is Neisseria meningitidis, a gram-negative diplococcus that can cause meningococcemia, leading to petechiae and meningitis. The infection is typically acquired through respiratory droplets, and the bacteria can invade the bloodstream and central nervous system. The treatment of choice is prompt administration of antibiotics, specifically ceftriaxone or cefotaxime, which are effective against N. meningitidis.
**Why Each Wrong Option is Incorrect**
* **Option A:** This option is incorrect because it does not address the gram-negative diplococci in the CSF, which is a critical diagnostic clue for N. meningitidis.
* **Option B:** This option is incorrect because it does not specify the correct antibiotic treatment for N. meningitidis meningitis. While penicillin is effective against many gram-positive bacteria, it is not the preferred choice for N. meningitidis.
* **Option C:** This option is incorrect because it does not address the need for prompt antibiotic treatment in cases of N. meningitidis meningitis.
**Clinical Pearl / High-Yield Fact**
In cases of suspected N. meningitidis meningitis, it is essential to administer antibiotics promptly, ideally within 30 minutes of diagnosis, to prevent further complications and improve outcomes.
**Correct Answer: D. Ceftriaxone.