American Board of Internal Medicine (ABIM) Certification Practice Exam

What is NOT a common sign of meningococcemia?

1. Fever

2. Rash

3. Fatigue

4. Chest pain

The correct answer is: Chest pain

Meningococcemia is a serious bloodstream infection caused by Neisseria meningitidis, a bacterium that can lead to sepsis and disseminated intravascular coagulation. Among the common signs of meningococcemia, fever, rash, and fatigue are frequently observed. Fever is a typical response to infection, as the body raises its temperature to fight off pathogens. In meningococcemia, patients often present with a high fever as part of the systemic inflammatory response. A rash is also a hallmark of meningococcemia. The rash usually appears as petechiae or purpura, which are small, red or purple spots that do not blanch when pressed. This occurs due to vascular damage and thrombocytopenia, leading to bleeding under the skin. Fatigue is a common symptom in infections such as meningococcemia, resulting from the body’s energy depletion in fighting the infection, along with the physical and psychological toll of being ill. In contrast, chest pain is not a classic symptom of meningococcemia. While some patients may experience chest pain, it is not a direct or common manifestation of this type of infection, making it the odd one out in this context.