A 2 year old boy after two days of persistent fever and irritability

Question Number 1176

A 2 year old boy is brought to the pediatrician by his father after two days of persistent fever and irritability. The child has been eating somewhat poorly for the past two days. The child is sleeping in his father's arms but is easily aroused by verbal stimuli. A few macular, red, discrete lesions are seen on his chest and abdomen. His right tympanic membrane is slightly red. His blood pressure is 82/ 48, pulse rate 144 and respiratory rate 36. His rectal temperature is 38.4C.
The pediatrician proceeds to take blood tests. He notes that while taking the bloods the child, although distressed, cried minimally and resisted less than would be anticipated.
The blood results are returned an hour hour later and are unremarkable except for a white blood count of 15,200
The pediatrician decides to perform a lumbar puncture. A gram stain of the CSF reveals gram-negative, bean-shaped diplococci.
This boy has been sharing a cot with his twin brother called John. The father is concerned that John may also become ill.
John should be given prophylaxis with:

a) rifampicin
b) sulfonamide
c) penicillin
d) chloramphenicol
e) a polysaccharide vaccine

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