Meningitt (kilde: The Lancet)- be aware of early symptoms

Thompson MJ, Ninis N, Perera R, Mayon-White R, Phillips C, Bailey L, Harnden A, Mant D, Levin M

[The Lancet 2006; 367:397-403 (February 4 2006, online Januar 18)]


Classic symptoms of meningitis are high fever, neck stiffness, photophobia, severe headache, drowsiness/irritability/confusion, bulging fontanelle, nausea/vomiting, and petechial rash.

Most children with meningitis in this article only had vague symptoms the first 4-6 hours, but were close to death within 24 hours. Only half of them were admitted to hospital at the first consultation.

Something to learn from?

The authors recommend general practitioners and parents to pay more attention to early septic symptoms, rather than only the classical symptoms of meningitis.

The sequence of symptom debut, summarized:


Early symptoms (7-12 hours)
Leg pain
abnormal skin colour
breathing difficulty
cold hands and feet

Classic symptoms (13-15 hours)
haemorrhagic rash (petechia)
neck pain or stiffness
bulging fontanelle

Late symptoms (16-22 hours)
confusion or delirium


Read the article:

Clinical recognition of meningococcal disease in children and adolescents



Click here to read this presentation in Norwegian


Presented by: Arne Westgaard, 26.01.2006, updated 08.03.2006

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