161.2 📚 國考版

161.2.0.1 必背 — 細菌

• Gram - kidney bean diplococcus
• Glucose + maltose fermenter (vs N. gonorrhoeae glucose only)

161.2.0.2 必背 — 臨床

• Meningococcemia ± Waterhouse-Friderichsen
• Purpura fulminans / petechial rash
• Meningitis
• 兩 overlap

161.2.0.3 必背 — Risk Groups

• 青少年 + 軍/宿舍 + 朝聖 + 無脾 + complement deficiency + eculizumab

161.2.0.4 必背 — Treatment

• Ceftriaxone (empirical) → PCN G if susceptible
• Vanco + ceftriaxone + dex if community meningitis empiric

161.2.0.5 必背 — Prophylaxis

• Cipro 500 PO × 1 for close contacts
• (Rifampin, ceftriaxone IM, azithro alt)
• ≤ 24 hr 內最佳

161.2.0.6 必背 — 疫苗

• MenACWY 11-12 + 16 (routine)
• MenB 16-23 (shared decision)
• MenABCWY (Penbraya) 2023 FDA
• Hajj + military + 無脾 + complement def

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