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Fever and petechiae/purpura
Acute meningococcal disease (caused by the bacterium Neisseria meningitidis) is a potentially devastating cause of
The most recognisable presentations of acute meningococcal disease are sepsis with a progressive non-blanching petechial/purpuric rash, and meningitis
with or without sepsis and rash. Rarer presentations include septic arthritis, pneumonia, pharyngitis and occult bacteraemia.
Note: a blanching rash does not exclude meningococcal disease (can initially be macular, maculopapular)
Examples of rash:
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Investigations should not delay
Duration of antibiotics is generally 5-7 days.
Meningococcal disease is spread person-to-person by respiratory droplets.
Patients should be isolated and droplet precautions continued for 24 hours after administration of appropriate antibiotics.
All cases of presumed or confirmed meningococcal disease should be urgently notified to the Department of Human Services by telephone 1300 651 160 (fax 1300 651 170) (after hours pager 03 9625 5000, pager number 46870)
Link to DHS notifications (including form)
Prophylaxis should be given to contacts as soon as possible
Additional vaccinations for close contacts may be considered. This will be directed by the responsible public health service.
Rifampicin 10mg/kg (max 600mg) 12-hourly for 4 doses
Ciprofloxacin 125mg single dose (
<5yo) or 250mg single dose (5-12yo)
* Inform patients/carers that rifampicin causes orange/red discolouration of tears and urine and negates the effect of the oral contraceptive pill.
All cases of suspected meningococcal disease in children.
All cases of acute meningococcal disease should be managed in a facility with the capacity to provide paediatric intensive care. If these facilities are unavailable, the patient should be stabilised and transferred as appropriate.
For emergency advice and paediatric or neonatal ICU transfers, call the Paediatric Infant Perinatal Emergency Retrieval (PIPER) Service: 1300 137 650.
Can be found at RCH Kids Health Info
All patients should be admitted under General Medicine.
If severe sepsis, shock, or meningitis, consider consulting the Paediatric Intensive Care Unit (x52327).
If prophylaxis is required after hours, a limited supply of rifampicin is available in the Emergency Department (after-hours cupboard) and in the PICU/Rosella medication room (cupboard below bench).
Last revised June 2017