Overview
Introduction: the First Clinical Impression
An otherwise healthy adolescent with fever, myalgia, vomiting, and a rapidly spreading non blanching rash can deteriorate before confirmatory tests return.
An otherwise healthy adolescent with fever, myalgia, vomiting, and a rapidly spreading non-blanching rash can deteriorate before confirmatory tests return. Meningococcemia is invasive Neisseria meningitidis infection in the bloodstream; meningitis may occur at the same time. Treat the combination of systemic toxicity, a non-blanching rash, and poor perfusion as a time-critical sepsis pattern: apply droplet precautions, call for resuscitation support, establish intravenous access, collect cultures only if doing so will not delay treatment, and ensure the first dose of IV ceftriaxone is given within 1 hour. The immediate threats are septic shock, disseminated intravascular coagulation, purpura fulminans, and adrenal haemorrhage. [1][2]