Urgent care staff must be alert to atypical signs of life-threatening meningococcal septicemia

A case study, published in Emergency Nurse, reveals how easy it is for such symptoms to be missed, delaying diagnosis and treatment of a patient with the life-threatening condition.

The patient, a 36-year-old woman, presented at an emergency department with intense pain in both legs and a blotchy rash, also on her legs. She was given various drugs, including codeine and subsequently intravenous morphine, with no effect on her 10/10 pain score.

Four hours after presentation and nine hours after onset of symptoms she was transferred to the intensive care unit for further investigations and support, and eventually diagnosed with meningococcal septicaemia and transferred to a specialist neurological unit. At the time of going to press, her prognosis was uncertain.

The article states the patient had some signs and symptoms of bacterial meningitis but not typical ones such as headache, neck stiffness and light sensitivity. Staff, therefore, decided to manage her pain before attempting diagnosis.

The author recommends that nurses and doctors working in emergency care settings are trained to recognize the atypical signs and symptoms of meningococcal septicaemia, in line with national guidelines and sepsis bundles.