Letter: Advice for GPs on a difficult diagnosis

Dear Editor

I read with interest the practice dilemma article 'A disagreement over a diagnosis'.

The dilemma related to a senior GP in the practice superficially viewing a 'tiny spotty macular rash' on a child who looked well and on his superficial viewing was doubtful of the diagnosis.

Young children in the early stages of meningococcal disease can sometimes appear relatively well, even when the disease is far advanced.

A macular or maculopapular rash does not exclude meningococcal disease.

Also, the classic meningitis symptoms would be absent in patients suffering from meningococcal septicaemia.

The Meningitis Research Foundation has published 'Guidance Notes for GPs - diagnosis and treatment in general practice', which has been endorsed by the BMA.

This booklet is freely available to GPs to help in their diagnosis of meningococcal disease.

An additional help for GPs is an in-depth article published this month by the Medical Protection Society - 'Don't get caught in the rash trap'.

This article deals with the diagnostic pitfalls of acute bacterial meningitis and septicaemia.

Julia Warren, Head of communications, Meningitis Research Foundation

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