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034 HSP Not Meningitis

Situation

Child had a non-blanching rash: it was Henoch-Schönlein purpura.

Background

18 month old girl presented with cough, widespread non-blanching rash, worse on legs and swollen ankle. CRP was 25. HSP was diagnosed clinically [no antibiotics given]; patient admitted to paediatrics and discharged from hospital the next day.

Assessment

The child had HSP not meningitis.

Rash similar to this:

https://pediatricimaging.org/diseases/henoch-schonlein-purpura/

Recommendation

If a child presents with a non-blanching rash, meningitis should be considered immediately.

However if the child appears non-toxic and the rash is predominantly on the buttocks/legs consider HSP as a diagnosis.

If in doubt simply ask a senior colleague for their opinion although if there is still uncertainty its safer to treat as meningitis.


PLEASE DO NOT INCLUDE ANY PATIENT IDENTIFIABLE DATA OR GEO-LOCATION DATA IN THE SUBMISSION OR IN ANY ATTACHED IMAGES

Emergency Cases Northwest Group


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