Meningitis and meningococcal
WHAT IT IS: Meningococcal disease refers to meningitis and meningococcal septicaemia caused by the Neisseria meningitidis bacteria.
HOW IT IS IDENTIFIED: Look for the "pin-prick" rash in any unwell child. The child may also have a fever, breathing difficulties, difficulty rousing and high-pitched cry amongst other symptoms. The petechiae (small red/purple/brown purpura) do not disappear when pressure is applied to the skin in 50-75% of cases (non-blanching). They are caused by bleeding into the skin. Maculopapular rashes can also appear. These patches can become larger and lead to tissue necrosis. Any part of the body may be affected but it most commonly affects the trunk and limbs. Particular attention should be paid to dark skin as lesions might be subtle. Ensure adequate lighting and ask the patient's parents if they have noticed any new marks. Lesions should be documented accurately. Do not delay treatment, meningococcal disease is a medical emergency. Source: A Handbook Mind The Map, Clinical signs in Black and Brown Skin. Mukwende M, Tamony P, Turner M