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.
Discussion 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
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