When is Meningitis not Meningitis?

The wee lad gave us and the doctors a wee scare today with a high temperature, vomiting, severe headache and a rash on his forearm that didn't disappear when rolled with a glass.

So his first ride in an ambulance and doctors didn't want to delay the ten minutes it would have took to wait for an anesthetic cream to work, so they freeze sprayed the back of his hand and stuck in a drip, queue much screaming from Euan. There was a fair bit of blood and it must have been painful poor boy.

So they took blood samples and the results came back about an hour ago, negative for Meningitis (Phew!). He perked up a lot in the last couple of hours, and seems quite well, temperature down, says the head is getting better, and hasn't vomited since about 8pm, but he still has this rash like he's been pr1cked with a load of needles. The doctors agree is is spots of blood coming to the surface under the skin, but haven't come to any conclusion as to what it is.

So I just got home and he and Mum are spending the night in the childrens ward.

Now, I'm not looking for medical advice on a biking forum , but there are a few doctors and nurses and a lot of parents on here.

What have you seen in the past that it could be?

I'm revising for my medical finals at the moments so a rarity of actually being clued up.

Firstly, I'm sure it's all been a bit distressing and I hope the little fella makes a quick recovery. A rash that doesn't disappear with glass is known as a non-blanching rash. The good news is that only 10% of these are attributable to meningitis or other infections, with the vast majority being benign and self limiting. It is of course important to rule out the former due to complications that can arise from delayed treatment.

Google 'non blanching rash in children' and you'll have a fair bit of information at your disposal.

I find it odd though that you mentioned the bloods came back and they had excluded meningitis. The absolute gold standard and most accurate diagnostic method for meningitis is a lumbar puncture, where cerebrospinal fluid (spinal fluid taken from the lumbar region with a needle) is analysed. Sometimes there may be certain reasons why they may delay doing a lumbar puncture, but are you certain that they have excluded the diagnosis based on the bloods alone?

Like I said though, rest assured that the vast majority of these presentations are not sinister. Nontheless, the diagnosis can sometimes be missed which is the last thing anyone wants, so always better to treat these things with more caution. It may be worth asking the senior doctors tomorrow about the lumbar puncture. They may have put if off for a reason, but I will be surprised if they don't eventually end up doing one. Sooner is much better than later.

Hope it all works out and that the little one is out in no time. We adults hate hospitals and children hate them even more!

Originally Posted by thulfi

Google 'non blanching rash in children' and you'll have a fair bit of information at your disposal.

I find it odd though that you mentioned the bloods came back and they had excluded meningitis. The absolute gold standard and most accurate diagnostic method for meningitis is a lumbar puncture, where cerebrospinal fluid (spinal fluid taken from the lumbar region with a needle) is analysed. Sometimes there may be certain reasons why they may delay doing a lumbar puncture, but are you certain that they have excluded the diagnosis based on the bloods alone?

I questioned it directly "so no sign of meningitis in the bloods?", the reply was "the bloods look fine, no infections are showing up at all". She did seem a little cagey about it though.

However, there are three children in the childrens ward tonight with similar symptoms (chatting with parents in the tea/coffee area), one was a 3 1/2 month old baby who has had a lumbar puncture and spinal fluids taken.

Note that he had perked up a lot and was starting to look and behave normal again in the last 90 minutes before he settled down for the night in the childrens ward and I left the hospital, the rash wasn't spreading any further. The A&E doctor said he more comfortable on seeing him chatting and playing again that we weren't dealing with meningitis, but said until blood results were back, they couldn't rule it out.

Originally Posted by thulfi

Google 'non blanching rash in children' and you'll have a fair bit of information at your disposal.

Thanks for that. Done some googling, and the rash he has is definitely "Petechiae", pin-head sized red dots.

I can't help on this one but I hope the wee man is feeling better soon. Poor wee falla!

Col, thats really crap for the little dude, how fecking scary for you and Sandrine.

An old neighbours daughter in the 80's contracted meningitis and died so quickly because they didn't get treatment quickly enough, you done the right thing by getting him to A&E asap, also they are more switched on about this illness now and a lot more reactive.

Hope he gets better asap, times like this I'm glad I'm not a parent, dunno how id cope with this stuff.

I'm not sure our speculation will be of any help so I'll just say I'm glad the little one has perked up and hope you and Mrs Ralph are feeling a bit more at ease

[maviczap]

There's some nasty bugs going round at the mo, and the rash you describe is simialar to what my youngest had over half term

She was sick and high temperatures every day before the calpol took effect, 38.9 deg

Rang the surgery who gave advice, but calpol managed the situation, although it lasted 5 days in all, which wasn't nice for her. The rash appeared on the last but one day she was ill.

The last day she perked up and was running around as normal, she went up stairs and fainted!

Luckily she fell into the laundry basket, so a soft landing, but my eldest daughters screams weren't good for my ticker.

Took her to the doc and got the all clear, poor little mite had run out of fuel, so spent the rest of the holiday eating.

The school sent out a letter the first week back at school, saying there had been some cases of 'slapped cheek' which is some form of virus.

So I hope your lad is better now, mine still looks a bit pale, but is back to her good sleeping pattern

[dizzyblonde]

When I was a kid, I had 'Meningitis that wasn't meningitis' one xmas. Apparently the family spent xmas with the curtains closed, as I was so desperately ill I couldn't bare light, threw up everywhere and had the usual symptoms!
These were the days when you probably didn't rush off to the hospital, as the rash with the glass thing wasn't pushed as a sign to look for. I was taken to the doctor when the surgery was open, and the doctor said 'yup she probably had meningitis!'

NICE
Sounds like MiniRalph is getting better , poor fella!