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The child with a non-blanching rash: how likely is meningococcal disease?
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  • Published on:
    Are there afebrile children with petechial rash who need neither investigation nor treatment?

    Dear Editor,

    Previous studies have reported on the combination of fever and rash. The paper by Wells et al [1] and the letter from Jones et al [2] are particularly valuable as they investigate afebrile children with a rash.

    Jones et al had 31 patients, and none had meningococcal disease. However, Wells et al report finding 5 patients with meningococcal disease who were afebrile. May we have some clinic...

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    Conflict of Interest:
    None declared.
  • Published on:
    reply to Dr Rod Phillips

    Dear Editor,

    In reply to Dr Phillips' enquiry, four of the twenty four patients with proven meningococcal disease had a petechial rash alone, with no purpura. These are the clinical details of the four:

    Case 1
    A 3 month old with the clinical features of meningitis. The infant was apyrexial but irritable and ill. There was a petechial rash on the trunk and upper limbs. A lumbar pu...

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    Conflict of Interest:
    None declared.
  • Published on:
    Petechiae or purpura in meningococcal disease
    Dear Editor,

    Wells et al are to be congratulated for their paper looking at children with a non-blanching rash. The data are indeed useful. One point where further detail would be useful is the distinction between petechial and purpuric rashes. The authors initially define petechiae as...

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    Conflict of Interest:
    None declared.