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My concern over advice on meningococcal disease signs

From Dr Declan Fox

Newtownstewart, Co. Tyrone

I am delighted at your coverage of the early signs of meningococcal disease (Clinical, 2 March). We owe the authors a vote of thanks for a classical description of signs that would have done any of the fathers of clinical medicine proud.

The big but is, of course, how common are severe leg pains, cold hands or feet and abnormally pale skin in viraemia? And in non-bacteraemic infection?

Certainly I would not be impressed at all with cold hands or feet if everything else looked OK. Likewise, some kids do go very pale when they get sick and some of them are very pale anyway.

I am concerned about rushing kids off to hospital without good cause and I would like to see someone quantify the risks of hospital admission. If one kid dies of hospital-acquired infection for every one saved from septicaemia then we are no further forward!

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