meningococcal disease

Question 1

possible meningococcal disease may present with

Answer 1

septicaemia (+- shock)
meningitis (+- raised intracranial pressure)
or both

Question 2

features of meningococcal disease in a child

Answer 2

fever, headache, neck stiffness, malaise, myalgia, arthralgia, nausea, vomiting, reduced conscious state

Question 3

features of meningococcal disease in an infant

Answer 3

fever, irritability, drowsiness, tachypnoea, pallor

Question 4

assessment of child with suspected meningococcal disease

Answer 4

non-blanching purpuric or petechial rash is typical but may or may not be present, particularly in early disease
recognise signs of shock and treat aggressively after antibiotic therapy

Question 5

meningococcal meningitis presentation

Answer 5

sudden onset and rapidly progressive symptoms
typical triad of fever, stiff neck and headache is not always present
myalgia and altered mental status is often present

Question 6

meningococcal septicaemia presentation

Answer 6

acute febrile illness, shock, profound malaise, myalgia or arthralgia, nausea and vomiting, altered consciousness, and a maculopapular/petechial rash (50% of cases)
rash is not always present and may begin as looking more like virl exanthem

Question 7

rash of meningococcal septicaemia

Answer 7

discrete 1-2mm lesions which may evolve to form larger eccymosis.
commonly appear in clusters in areas where pressure occurs eg. underwear and elastic bands, so the child should always be completely undressed

Question 8

investigations

Answer 8

nasopharyngeal swab
blood culture
FBC
CRP
Venous blood gas
meningococcal PCR
also maybe:
- coags profile, DIC screen
- CSF MC&s, culture and PCR
- skin lesion/joint aspirate

Question 9

public health notification

Answer 9

meningoccocal disease is notifiable