Improving the early recognition of meningitis and septicaemia in children and adolescents.
Diane McLeod, Dr Anthony Harnden, Dr Matthew Thompson, Dr Rafael Perera, Dr Richard Mayon-White, Sue Smith, Tanya Haj-Hassan
- Start Date:
01 January 2006
Oxford University, Oxford, UK
Identifying children with meningococcal disease in primary care is challenging. Children may present in the early stages of the disease, before typical symptoms are apparent. In addition, although meningococcal disease is still the most common infectious cause of death in many developed countries, it is still extremely rare in comparison to self-limiting infections. Approximately 50% of children with meningococcal disease who are seen by a primary care physician are initially misdiagnosed. In a recent study of children with meningococcal disease we found that cold hands and feet, leg pain, and abnormal skin colour appear to be early clinical features of sepsis. One or more of these occurred in 72% of children, usually several hours before the "classic" features. In order to determine the diagnostic value of these symptoms in primary care, we need to determine their frequency in children with acute self-limiting infections in primary care. We therefore propose a prospective study of children presenting to their GP with acute infection. Prevalence of the early sepsis symptoms (as well as other meningitis symptoms) will be determined using a parental questionnaire. We will then be able to compare the frequency of the early sepsis symptoms in children with acute self-limiting infections, with those previously published in children with meningococcal disease. This will allow us to determine the diagnostic value of these symptoms in a typical primary care setting.