Meningococcal sepsis.
BACKGROUND
Meningococcal disease remains a significant illness with an overall mortality of around 8%. The majority of deaths occur in the first 24 hours, before the commencement of specialist care. Missing a diagnosis of meningococcal disease is a fear among health care practitioners.


OBJECTIVE
This article presents a guide to identifying the salient features of meningococcal sepsis and initial management strategies in the primary care setting.


CONCLUSIONS
Initial presentation is often nonspecific and therefore it is important to have a high index of suspicion in children presenting with fever, lethargy, myalgia, vomiting and headache. These children should be monitored and reviewed carefully. If a nonblanching rash develops, immediate treatment, liaison with a paediatric intensive care unit and urgent hospital transfer is required. Initial management involves assessment and regular review of airway, breathing and circulation. Antibiotics (preferably intravenous cephalosporin) should be administered before hospital transfer.
Rajapaksa
Shabna
S
Emergency Department, Royal Children's Hospital, Melbourne, Victoria, Australia. shabnarajapaksa@doctors.net.uk
Starr
Mike
M
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D016638:Critical Illness / Q000628:therapy; D042241:Early Diagnosis; D004638:Emergency Treatment / Q000379:methods; D005194:Family Practice / Q000592:standards / Q000639:trends; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008585:Meningitis, Meningococcal / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D008589:Meningococcal Infections / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D008991:Monitoring, Physiologic / Q000379:methods; D017410:Practice Guidelines as Topic; D011379:Prognosis; D016019:Survival Analysis
D000900:Anti-Bacterial Agents