Meningitis
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Some illnesses such as meningitis, Bird Flu, cancers and suchlike catch the public's fears of fatal illness being missed in the early stage when it could have been treated.
The anxiety that such conditions provoke is out of any proportion to the risk of a particular patient actually having a potentially serious problem. As an example. The mere mention of meningitis strikes fear into the heart of most parents. A single case in a town will have parents clamoring for emergency appointments for their children not just in that town but for miles around. The question is always the same. " I am sure there is nothing much and it's just a virus but will you "check him out" just to make certain that it is not meningitis".
The truthful answer to this has to be NO. Because it is just not possible, any slightly off-color or feverish child could have meningitis, it is just not very likely.
The real problem is that it makes such a difference to chances of good recovery if the disease is treated early, before serious damage is done. Unfortunately it is just about impossible to acheive this in most cases. There are the classic symptoms and signs of Meningitis, such as, neck stiffness, aversion to light and / or a typical skin rash, in a child who has a fever usually a severe headache and is obviously very ill.
Any Doctor not suspecting Meningitis if a child was brought in in this condition, would deserve shooting !! Such things can not and must not be missed. The problem is that these are late signs of Meningitis, by the time they develop the chances for recovery are poor with even the best treatment. If a child was taken to the Doctor's with the early signs of Meningitis, then almost certainly the Doctor would not make the diagnosis. The reason being that the child would be a bit off color, have a temperature, feel a bit headachy and probably have a runny nose, sore throat or other non specific symptoms. In short the child would be no different to the twenty other feverish off-color children that the Doctor had already seen that day. A few hours later the same child could be on a life support machine more dead than alive. But how was the Doctor to know that. Sadly the child does not come into the Surgery with Meningitis written across the forehead !! One can not get any help from Mum as she just wants to be told that it could not possibly be anything serious. Whilst 99.9% of times such advice is correct, it can not be said to be absolutely truthful.
So how do we diagnose Meningitis then ?
Sadly in most cases we don't, at least not with the more serious "Meningococcal" form of the disease. There are less serious forms and these do not progress so rapidly, giving the signs time to evolve so that a Doctor can make the diagnosis. These forms of Meningitis are mostly viral or caused by less virulent bacteria than the Meningococcus. Here with treatment less than full recovery is unusual, even if there is a delay in starting treatment. About the only way of diagnosing early Meningoccal disease is by having a "guardian angel" sitting on your shoulder in surgery, by incredible good luck where the clinicians sixth sense gently tells him that something seems not quite right with this child, and he arranges for the paediatrician on duty to have a look at the child. The third and most common way of arriving at an early diagnosis is however sheer fluke and good luck.