Question:
My 3 yr old son died on 4th Jan 2005, of Men B only hours after an out of hours doctor told me I was an over reacting mother and my son had flu. My question is can the Kernig test be carried out on a child sitting up on a parents lap, as I questioned this and dr said "who is the dr here?" I was concerned as I had had to carry my son to dr as his legs hurt.
Answer:
Professor Adam Finn says:
I'm very sorry to hear of your loss. You must still miss him a lot. It must be very upsetting to remember being told you were over-reacting.
The early stages of meningitis are very similar to ‘flu and the infection can progress very fast in some children so that, as in your son's case, it is only a matter of hours before they are very dangerously ill.
Leg pains have been recognised as occurring in children with meningococcal disease fairly recently. A paper was published in 2006 in the Lancet about this.
In answer to your question, the truth is that Kernig's sign, which is showing pain when you straighten out a bent leg at the knee, is not a very reliable way to look for meningitis especially in young children. Not only is the sign often negative in children who have meningitis, but a sick child, especially one with painful legs, can't really tell you or show whether moving his legs around causes pain or not, because just about everything is painful and distressing. So overall, I doubt whether it would have made much difference if he had been lying flat or sitting on your knee.
The other thing to mention is that although MenB can cause meningitis, it also causes blood stream infection or septicaemia and this second form of the condition is even more dangerous. Although some children have both meningitis and septicaemia, most have either one or the other and, of course, children who just have septicaemia don't have signs of meningitis. The most important sign of septicaemia is the rash which doesn't go away when you press it.
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Reply #1 on : Mon November 07, 2011, 05:08:55
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