Fillers A memorable patient

A headache to diagnose sometimes

BMJ 2001; 323 doi: (Published 10 November 2001) Cite this as: BMJ 2001;323:1110
  1. Peter Thatcher, specialist registrar in gastroenterology
  1. St Thomas's Hospital, London

    A 17 year old man was referred with a 12 hour history of generalised headache, mild photophobia, and a rash on his body that was macular and blanching. The rash, though not classic for bacterial meningitis, was developing “in front of my eyes.” The patient had a temperature of 37.4°C, no neck stiffness, and a negative Kernig's sign. There were no focal neurological signs. He seemed clinically well, talking and smiling with no great discomfort. His white cell …

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