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Do you know what symptoms to look out for?

That got your attention, and rightly so. Let’s be honest, when we see a rash it’s the first thing we think of. It’s the most severe of all the rashes and should be the very first thing we check for, to hopefully rule out the condition. However, not all rashes are meningitis and it’s important to be able to differentiate the types of rashes so you know when to get immediate help and when you can try to manage it at home.

Could you recognise a rash associated with meningitis?

Heat rash is very common in babies and young children and can appear quickly and be scary to look at.

Would you know how to test the differences?

Before I go any further, I would just like to point out that you do not always get a rash with meningitis. The rash is caused by blood poisoning (septicaemia) and often does not appear in the early stages. Just because there isn’t a rash does not mean you are not dealing with a case of meningitis. You can have meningitis without septicaemia. If meningitis is suspected it should always be treated as a medical emergency, even if there is no presence of a rash.

Meningitis is caused by an infection of the membrane that surrounds the brain and spinal cord (the meninges). It can be caused either by bacteria or by a virus. The bacterial type is the most severe and those most at risk are the under 5s and teenagers. Viral meningitis is more common and, thankfully, often has less serious complications.

Apart from the rash, there is a number of other symptoms to look out for, including:

  • Severe headache
  • Fever, high temperature
  • Nausea/vomiting
  • Aching muscles, limbs, joint pain
  • Sleepiness, drowsiness or being difficult to wake
  • Confusion, deliriousness, disorientation
  • Pale mottled skin (often described as looking like corned beef )
  • Cold hands and feet
  • Rash anywhere on the body (remember to check soles of feet, inside mouth, eye lids)
  • Fast breathing, difficulty in breathing
  • Stiff neck or dislike of bright lights (both uncommon in young children)
  • Seizures

These symptoms can appear in any order and some may not appear at all. Meningitis is scary, there is no denying that, but I cannot stress highly enough how prompt action can save your child’s life. I have, sadly, seen many cases of it and have been able to help hospital doctors rule out many others. The one common factor in all of the cases I have assisted with is…time. In each case the child has gone downhill rapidly. I don’t mean in days; meningitis can literally kill in hours. If your child is rapidly becoming worse, then get help immediately.

The rash spots often look like red/brown pin pricks which, over time, can alter to form large red/purple blotches.

On darker skin it can be more difficult to notice the rash, so try looking on paler areas such as soles of feet/palms of hands/abdomen or inside the eyes or roof of the mouth.

The rash associated with meningitis does not blanch when an ordinary glass tumbler is pressed upon it. It does not alter, fade or change in any way when a glass is pressed upon it.

There are a number of other rashes that your child may develop at some time. Heat rash, viral rash, allergy to soap or laundry products, food allergy rash to name just a few.

If you are in doubt as to what the rash is, always perform the glass test first. If you are still in any doubt then seek emergency medical help.

Even doctors can find it hard to diagnose some rashes, so you’re certainly not expected to know them all. However, for your own peace of mind, find out the signs and symptoms of meningitis. There is a great free app for your phone to test your symptoms. To download it, visit the Meningitis Research Foundation at

The progression of meningitis can appear different in each case. There are two examples that stick clearly in my mind. One, a very tragic story I am afraid and another one with a completely happy ending.

A teenager came into A+E after a history of being unwell overnight. He had most of the classic meningitis symptoms specific to older children (dislike of bright lights, neck pain, blinding headache, acting confused). His symptoms had got worse by the following morning. By the time his parents saw he had a rash all over the trunk of his body he was clearly very unwell. He was confirmed as having meningitis and worryingly the rash spread quickly. He was admitted to intensive care and sadly had to have a partial amputation of one leg as the blood poisoning (septicaemia) had spread and caused gangrene. Following the amputation he did not improve and tragically died the following day.

The second story is of a young primary school pupil who became unwell at school. The school called her parents and asked them to collect her; at this stage her symptoms were very unspecific: temperature, earache and generally lethargic. Her parents couldn’t collect her immediately as they were some distance away. The child continued being closely monitored by staff. After a while she became increasingly sleepy and staff got more concerned. They rechecked and noticed a small blotchy/ red mark that looked like a bite on her ear lobe. The girl stated it was not normally there. She was taken to A&E and tests confirmed she did have meningitis. Appropriate action was taken and the child fully recovered. She was back at school, completely well three weeks later.

See what a difference prompt action can make? While not every child that contracts meningitis will fully recover, the chances are significantly higher the earlier you get help. Get up to speed with meningitis.

Cheryl Parkes


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