At 11:46 23/04/2007, you wrote:
>Had one of these in the surgery last week as did my partner and a
>further one today. Last week - child had been wretching, hence this
>may have been the cause. Today however - kid had not. He was apyrexial
>and nothing else could be found and looked well and was well. As I say
>- no coughing, vomiting or wretching.
>
>I sent him to paediatrics, as I always do, despite thinking not
>meningococcal. I do this because 20 years ago had such a kid one
>Thursady evening that I thought was completely innocent and this did
>turn out to be meningococcal.
>
>What do the panel think? More importantly, would you give penicillin
>to these kids?? Asking the latter as I discussed this with my partner
>and our Nurse Prcatitioner last week. NP asked what she should do if
>we were not here. I said that medicolegally and clinically the kids
>should be given penicillin if I half suspected Meningococcus. We were
>going to discuss as a significant event and thrash out whether to have
>a protocol to force us to give penicillin.
A) I agree they should all go to hospital
B) If they are clinically well (or not severely ill), and the
purpuric rash has been present for many hours, then they do not have
fulminant septicaemia. The arguments for giving penicillin might be
somewhat balanced and I'd be interested to know both what you
conclude and why. (NB It is recorded that some meningococcal disease
can be indolent or sub-acute, which why they SHOULD go to hospital)
Julian
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