A 19-year-old Student with Fever, Headache, Neck Stiffness and a Spreading Non-blanching Rash
A branching clinical case simulation for a patient presenting with fever, headache, neck stiffness, and a spreading non-blanching rash. Take a history, examine, investigate, diagnose and treat while the patient responds to every decision, then see the score by clinical domain with the reasoning for each mark.
Year 3medium20 min6 stages
- Patient
- 19 years, male
- Presenting complaint
- Fever, headache, neck stiffness, and a spreading non-blanching rash
- Decision stages
- History, Examination, Investigations, Diagnosis, Treatment, Monitoring
The presentation
You are the junior doctor in the emergency department of a district general hospital. A 19-year-old student has been brought in by his friends, complaining of a severe headache and a rash that has spread from his ankles to his trunk over the past few hours. He is febrile, tachycardic, and has neck stiffness. You have five minutes to decide your initial approach.
What this case teaches
- Recognise the clinical features of meningococcal disease. 2. Administer antibiotics before investigations when a non-blanching rash is present. 3. Determine when CT must precede lumbar puncture. 4. Manage contacts and notify public health.
How the case unfolds
- 1History: Key QuestionsHistory
- 2Examination: Focused AssessmentExamination
- 3Investigations: Immediate PrioritiesInvestigations
- 4Diagnosis: What is the working diagnosis?Diagnosis
- 5Treatment: Immediate ManagementTreatment
- 6Monitoring and Follow-UpMonitoring
The decisions available at each stage, and what each one costs or earns, appear when you run the case.
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A free account opens the simulator: the patient's observations move with your decisions, and every choice is scored and explained.
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Educational content for students and clinicians in training. It does not replace professional judgement, local protocols or current prescribing information.