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. 2001 Aug;85(2):160–165. doi: 10.1136/adc.85.2.160

Diagnostic assessment of haemorrhagic rash and fever

H Nielsen 1, E Andersen 1, J Andersen 1, B Bottiger 1, K Christiansen 1, P Daugbjerg 1, S Larsen 1, I Lind 1, M Nir 1, K Olofsson 1
PMCID: PMC1718873  PMID: 11466193

Abstract

AIMS—To establish criteria for early distinction between meningococcal disease and other conditions with similar clinical features, and to identify other causes for haemorrhagic rashes accompanied by fever.
METHODS—In a prospective study, 264 infants and children hospitalised with fever and skin haemorrhages were studied.
RESULTS—We identified an aetiological agent in 28%: 15% had meningococcal disease, 2% another invasive bacterial infection, 7% enterovirus infection, and 4% adenovirus infection. Five clinical variables distinguished between meningococcal disease and other conditions on admission: (1) skin haemorrhages of characteristic appearance; (2) universal distribution of skin haemorrhages; (3) maximum diameter of one or more skin haemorrhages greater than 2 mm; (4) poor general condition (using a standardised observation scheme); and (5) nuchal rigidity. If any two or more of these clinical variables were present, the probability of identifying a patient with meningococcal disease was 97% and the false positive rate was only 12%. This diagnostic algorithm did not identify children in whom septicaemia was caused by other bacterial species.



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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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