An 11 year old boy with chest pain and feverBMJ 2009; 339 doi: https://doi.org/10.1136/bmj.b4941 (Published 10 December 2009) Cite this as: BMJ 2009;339:b4941
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Response to BMJ 2009;339:b4941
Lida Panagiotopoulou, paediatric ST1.
Childrens Hospital, UHW, Cardiff, UK.
Correspondence to Lida Panagiotopoulou:
This response is regarding a very interesting and educative case
report of pericarditis complication following meningococcal disease.
The analysis of the case is excellent.
It highlights nicely the difficulty in the differential diagnosis of
pericarditis due to direct invasion from immune mediated reactive
It also indicates the difficulty in diagnosing pericarditis since even in
this case where significant infusion was present, ECG, cardiac
auscultation and initial CXR was normal.
I would like to cite a comment on the discrepancy on ceftriaxone
doses recommended in Australia and the UK.
According to the article, the ceftriaxone dose given for presumed
meningitis was 50 mg/kg IV every 12 hours.
In the UK, according to British National Formulary for children (BNFc
5.1.2) the ceftriaxone dose recommended for meningitis is 80 mg/kg once
I was wondering if this is due to evidence based discrepancy on stain
incidence or/and microbiological sensitivities between Australia and the
A similar discrepancy was noted on the empirical intramuscular dose
of ceftriaxone (25 mg/kg), initially given by the local doctor. The BNFc
recommendation is 50 mg/kg.
Congratulations for the excellent article.
Competing interests: No competing interests