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Review
. 2006 Sep 30;333(7570):685-90.
doi: 10.1136/bmj.38968.683958.AE.

Meningococcal disease and its management in children

C Anthony Hart  1 , Alistair P J Thomson
Affiliations
Review

Meningococcal disease and its management in children

C Anthony Hart et al. BMJ. .
No abstract available

PubMed Disclaimer

Figures

Fig 1
Fig 1
Serogroups of Neisseria meningitidis identified in cases in England and Wales by age: January to March 2005
Fig 2
Fig 2
Electronmicrograph showing blebbing (b) of the outer membrane of Neisseria meningitides
Fig 3
Fig 3
Structure of cell wall of Neisseria meningitidis: 50% of the lipid in the outer leaflet of the outer membrane is lipo-oligosaccharide or endotoxin
Fig 4
Fig 4
Evolution of non-blanching rash in meningococcal disease. Petechial, purpuric, and vasculitic elements are appearing. The pictures were taken 30 minutes apart. (Reproduced with permission from: Riordan FAI. Factors associated with mortality from meningococcal disease in Merseyside children (MD thesis). Liverpool University, 1995.)
Fig 4
Fig 4
Evolution of non-blanching rash in meningococcal disease. Petechial, purpuric, and vasculitic elements are appearing. The pictures were taken 30 minutes apart. (Reproduced with permission from: Riordan FAI. Factors associated with mortality from meningococcal disease in Merseyside children (MD thesis). Liverpool University, 1995.)
Fig 5
Fig 5
The “tumbler test” is a way of confirming the non-blanching nature of the rash
Fig 5
Fig 5
The “tumbler test” is a way of confirming the non-blanching nature of the rash
Fig 6
Fig 6
The maculopapular rash of meningococcal disease, indistinguishable from maculopapular rashes in viral infections. (Reproduced with permission from: Marzouk O. Clinical and laboratory aspects of childhood meningococcal disease (MD thesis). Liverpool, 1993.)
Fig 7
Fig 7
Diagnostic and management pathway from primary care to paediatric intensive care unit (PICU): petechiae in children and meningococcal disease (MCD). (Each square represents one child.) *Range 30-180, but incidence of petechiae in primary care consultations for illness unknown. **Range 27-147, but incidence of petechiae in emergency department varies (Medline search May 2006)
Fig 8
Fig 8
Diagnosis of petechiae in children and meningococcal disease. CRP=C reactive protein; FBC=full blood count; IV=intravenous; MCD=meningococcal disease; PCR=meningococcal polymerase chain reaction; SVC=superior vena cava; T/S=throat swab for meningococci; WBC=white blood cells
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References

    1. Thomson APJ, Riordan FAI. The management of meningococcal disease. Current Paediatrics 2000;10: 104-9.
    1. Molesworth AM, Thomson MC, Connor SJ, Creswell MP, Morse AP, Shears P, et al. Where is the meningitis belt? Defining an area at risk of epidemic meningitis in Africa. Epidemiol Infect 2002;96: 242-9. - PubMed
    1. Yazdankhah SP, Caugant DA. Neisseria meningitidis: an overview of the carriage state. J Med Microbiol 2004;53: 821-32. - PubMed
    1. Kvalsvig AJ, Unsworth DJ. The immunopathogenesis of meningococcal disease. J Clin Pathol 2003;6: 417-22. - PMC - PubMed
    1. Health Protection Agency. Laboratory reports of invasive meningococcal infections, England and Wales: weeks 50-53/2004. CDR Wkly (Online) 2005;15(16).

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