Thursday 12th July 1990   Morning surgery 10.33

Meningococcal meningitisrash

“I’ve got a 14 year old year old boy with suspected meningococcal meningitis. He has been unwell with a high temperature and abdominal pain for 24 hours. This morning, he did not want to get out of bed. He has vomited twice. He is pale and sleepy. GCS is 13. Temperature 39.2. Pulse 134. Respiratory rate 22. Blood pressure is low: 80/40. CRT is 5 seconds. He’s got cold hands and feet. Chest is clear and abdomen normal but he has large, dark red blotches on both legs. They do not blanch on pressure.”

If a patient with meningococcal meningitis is going to survive, antibiotics must be started as soon as possible. Dr Lewis sent me to the treatment room to get a penicillin injection while she finished speaking to the on-call paediatrician.

Suspected meningococcal meningitis.