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Emergency medicine

Headache, rash and the fear of deadly meningococcal sepsis

Gordian Fulde

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Abstract

Recent media cover, especially criticism of meningococcaemia management, has again raised awareness of meningococcal septicaemia.

Article Extract

Whether in your general practice or the local hospital’s emergency department where you work regular shifts, let alone in your private life, you fear the presenting symptoms of headache and rash.

The presenting problem

It was midday on your day shift at the emergency department when an ambulance brought in a 35-year-old woman with joint pain and a skin rash. Bilateral hand and finger joint pain had begun the afternoon before and had been preceded by a skin rash first noticed that morning. On the morning that she presented, she had all-over joint pain, a slight headache and mild photophobia. She denied any nausea, vomiting or fever, and had not taken any analgesics. She said that she had asthma but was not taking any medications for it, and that she had once tested positive to having had glandular fever but did not have a recollection of ever being sick with the infection.

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