This unfortunate 27 year old pregnant woman collapsed at home with a seizure and then died soon after.  She had a disseminated W135 serotype infection – this serotype has been associated with a number of recent severe cases in Hunter New England.  Neisseria meningitidis case presentation Dr Rexson Tse May 2016

Perhaps there were no preventable features in this case, however useful to remember some key issues:

• acute meningococcal sepsis may cause death in the absence of a rash- the rash takes at least 12 hours to appear and it often has a blanching maculo-papular appearance at first
• conversely, an acute febrile illness that presents with a rash that has appeared in the first 2 days should lead to a suspicion of bacterial sepsis as viral exanthems will generally appear later in the illness – eg 4-5 days +
• in dark skinned individuals, always check the conjunctiva and oropharynx for…