happy toddler looking out of cardboard house

Meningococcal Rash: The Warning Signs – Dr Sophie Carter

Parents often come to me in a panic about meningococcal disease. They’re usually worried that their child’s rash is a sign of the deadly condition.

I’m in a fortunate position to instantly put their minds at rest by assuring them the rash is caused by something MUCH less severe. Childhood rashes are incredibly common.

A meningococcal rash is often a later-stage and dangerous sign of the disease. You would no doubt notice other serious symptoms before a rash appears.

Below, I’ll outline five common indicators of a meningococcal rash:

  1. Pink, reddish and purple marks
  2. Drinking glass test
  3. Rash isn’t caused by trauma
  4. Rash is accompanied by other symptoms
  5. Lack of scratching

Believe me, you wouldn’t be reading this blog post if your child already had the disease. It’s more likely that you’d already be at the nearest hospital’s emergency department hoping for the best.

Meningococcal Disease Facts

Meningococcal disease is a rare yet very serious bacterial disease (not a viral disease). Here’s an overview:

  • The two most common types of the disease are meningitis which affects the brain and spinal cord, and septicaemia, affecting the blood
  • Rashes are most common in septicaemia, though people can be infected with both types and still exhibit a rash
  • Most at risk are those aged 0-5 years old and 15-24 years old
  • Though not easily spread, the disease is transmitted through mucus (saliva)
  • Occurrences in winter and spring are most common, due to increased mucus production from common colds and hay fever
  • It can cause death in a number of hours if not treated immediately
  • Along with a high fever, symptoms are wide ranging.

5 Signs of a Meningococcal Rash

To help put parents’ minds at ease, here are five tell-tale signs that a rash is possibly a symptom of meningococcal disease.

1. Pink, reddish and purple marks

A meningococcal rash is caused by bleeding under the skin. It can start as pink/reddish pinprick-sized lesions, progressing to larger purple bruise-like markings as the rash spreads and haemorrhages.

The rash is often harder to notice in darker-skinned people, especially during the early stages. Paler areas of their body should be observed, such as their palms and mouth.

meningococcal sepsis rash

2. The drinking glass test

Many harmless rashes fade and become lighter (known as ‘blanching’) when a drinking glass is placed against the affected area.

A meningococcal rash will often keep its red or purple colour under the same test, though this isn’t 100% definitive.

3. Not caused by trauma

If your child has an isolated area with a rash, it’s likely not caused by meningococcal disease. I see a lot of worried parents whose children have merely scrapped their knees or have been scratching part of their bodies.

Meningococcal rash often spreads over large areas such as the legs. It’s very obvious something serious is going on.

4. Accompanied by other symptoms

As touched on above, rashes are usually a relatively late symptom on meningococcal disease. Your child will show signs of illness before a rash appears.

An infected child’s rash is typically preceded by symptoms such as fevers, loss of appetite, vomiting, muscle and joint pain (often neck stiffness), lethargy, irritability and headaches.

5. Lack of scratching

Unlike many common rashes, the meningitis rash isn’t itchy. As children’s skin is typically more sensitive than adults’, a lack of scratching can be a bad sign.

Since such a rash is quite prominent and can look pretty nasty, it will often seem quite unusual that a child isn’t scratching it.

Take Immediate Action if Concerned

Above all, if you have any concerns that your child has meningococcal disease call 000 immediately for an ambulance.

By the time a rash is present, it’s extremely serious and your child will need urgent IV antibiotics.

Meningococcal Vaccinations

Luckily there are now vaccines against all the common strains of bacterial meningococcal disease, including A, B, C. W and Y.

Many specialists believe the current schedule is inadequate to protect the population. Being a complex area, please speak with your GP if you have any questions or concerns.

Dr Sophie Carter is a GP at Doctors of South Melbourne. She’s has special interests in child and youth health and chronic & complex health needs.