Which early ‘red flag’ symptoms identify children with meningococcal disease in primary care?

Clinical predictors of antibiotic prescribing for acutely ill children in primary care: an observational study

“…Pulse and respiratory rate were only recorded in about half of all children despite this being specifically requested for the study. Recording of vital signs in routine clinical practice is likely to be even lower 38 This is higher than in the current study but excluded children without fever. Another reason for the difference may be because 'viral illness' was not included in the current study's definition of RTI.…”

“…40 Most of the studies discussed above present data collected prior to the data collection in the current study (2010). 16,38,40 One study presents more recent data from 2011-2012, which found a similar level of antibiotic prescribing among children as in the current study. 39 Children with abnormal ear, throat, and chest examination findings had an increased likelihood of receiving an antibiotic.…”

Caracterización clínica de los casos de enfermedad meningocóccica por serogrupo W135 confirmados durante el año 2012 en Chile

“…Un equipo de investigadores llevó a cabo un estudio de caracterización clínica en niños y adolescentes con sepsis meningocóccica y, observaron que en 72% de ellos se presentaron tres síntomas de aparición temprana (con una media de ocho horas): dolor de extremidades inferiores, manos y pies fríos, color cutáneo anormal. Asimismo, relacionaron la ausencia de signos clásicos con la baja derivación a un centro hospitalario (51% en la muestra del estudio) 18,21 . En ninguno de los 60 casos del 2012 en Chile, se describió la presencia de estos síntomas; no obstante, sí hubo un predominio de sintomatología inespecífica en la mayoría de los pacientes, y la derivación a un centro de alta complejidad, en global, ocurrió en 65,5% del total.…”

When and how do GPs record vital signs in children with acute infections? A cross-sectional study

“…The methods have been previously presented in detail. 10 In summary, children were recruited at point of presentation for an appointment with a GP. Children with a final diagnosis inconsistent with an acute infection (for example, minor trauma, atopic eczema, asthma, allergic rhinitis, or infantile colic), those with obvious minor focal infections of the skin in whom there were no systemic symptoms or concern about systemic illness (for example, paronychia, local fungal infections, or verrucae), and those in whom there was insufficient information to determine a diagnosis were excluded.…”

“…9 As part of a recent study of 'red flag' symptoms in children with acute illnesses in primary care, the study undertook a large cross sectional analysis of children presenting to GP surgeries in two areas of England. 10 As an additional component of the study the study examined the GP records of all children presenting with acute infections (febrile and non-febrile). This study reports on the frequency with which GPs recorded vital signs in this group of children, to compare with previous self-report, NICE recommendations, 1 and also to determine whether GPs use alternative methods such as non-numeric text to indicate the normality or otherwise of vital signs.…”