Haemorrhagic rash is the most important feature in diagnosing meningococcal disease in primary care
In primary care the emphasis on managing meningococcal disease is on early recognition and administration of parenteral antibiotics. On p 276 Granier et al describe a qualitative study of how meningococcal disease was diagnosed in 31 children admitted to hospital for the disease by their general practitioners. General practitioners recognised abnormally ill children with clinical features that differed from those in children with self limiting illnesses. Their knowledge of parents' help seeking behaviours influenced their decisions. Although a non-blanching rash was the single most important factor in recognising the disease, general practitioners should not be deterred from diagnosing meningococcal disease if the child is otherwise well or if the rash is scanty or unusually distributed.
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