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Your guide to meningitis misdiagnosis

Woman holding a glass on a child's arm - meningitis misdiagnosis

Meningitis is an infection that can develop rapidly and your child could become seriously ill within hours.  Failure by a GP or hospital doctor to diagnose meningitis quickly and accurately can result in permanent physical and psychological disabilities and, in some instances, the loss of life.

In many cases, meningitis may initially develop without any recognisable symptoms or symptoms that are mistaken for a different condition.  As there are many different types of meningitis, it is crucial that a doctor performs a number of appropriate tests so that a correct diagnosis can be made.

Following recovery from meningitis and septicaemia, you or a loved one may be left with a severe and permanent disability.  When a life-changing, permanent injury, which could have been avoided, is caused by symptoms that were missed, misdiagnosed or mistreated, the impact upon the whole family can be devastating.

Cases of meningitis misdiagnosis can often be complex

Cases of clinical negligence involving the misdiagnosis or substandard treatment of meningitis can often be complicated, but a hospital trust has a legal ‘Duty of Candour’ to both inform and apologise to patients if mistakes have been made while in their care.

However, it may not always be so straightforward to obtain a proper explanation as to what happened and where the responsibility may lie.

It is vitally important that you seek a legal expert who  has specialist knowledge of the key medical issues, together with a sympathetic and sensitive understanding of how everyone involved is affected.

Your Legal Friend has many years of experience in successfully resolving complex  clinical negligence cases. We can help you:

  • Find out the reason why  you or a member of your family were not given the duty of care you were owed.
  • Secure appropriate compensation to ensure that the financial demands of providing the necessary special care, support, treatment and equipment will be properly met, both now and in the future.

How common is meningitis?

  • Around 2,350 single cases of ‘bacterial’ meningitis and septicaemia (blood poisoning) were diagnosed in the UK, 2011-12                                    (NHS UK)
  • An estimated 3,200 people contract ‘uncontrolled’ bacterial meningitis and associated septicaemia in the UK each year.                 (Meningitis Research Foundation)
  • Meningococcal disease, meningitis or septicaemia caused by Neisseria meningitidis bacteria results in about 1 death in every 10 cases.                                      (NHS UK)
  • Most fatalities are caused by septicaemia rather than meningitis.                                                (NHS UK)
  • Up to one in four may experience complications of meningitis, such as hearing loss, following bacterial meningitis.                                                (NHS UK)

What is meningitis?

Meningitis is an infection of the meninges which are protective tissue linings or membranes that surround the brain and spinal cord.  Infection causes the membranes to become inflamed, which in some cases can damage the nerves and brain.

Two main types of meningitis

It is vital that a diagnosis distinguishes between the two main types of meningitis.

  • Viral meningitis – caused by viruses spread through coughing, sneezing and poor hygiene.
  • Bacterial meningitis - caused by number of different bacteria, such as Neisseria meningitidis or Streptococcus pneumonia,

Viral meningitis - is usually an unpleasant but relatively mild and less serious condition,that most commonly affects babies and young children. Normally there is a complete recovery from the disease but more severe, long term symptoms may also result.

Bacterial meningitis - is the more serious form of meningitis and requires immediate expert medical assistance.

A misdiagnosis can occur between the two types of meningitis when the deadly bacterial meningitis is often dismissed as a viral illness by a doctor.  This could mean the appropriate tests, including a CT scan or lumbar puncture, are not carried out to confirm that bacterial meningitis is not the cause.

Meningitis can appear in several forms, including:

  • aseptic meningitis
  • gram negative
  • haemophilus influenzae b (Hib)
  • meningococcal
  • pneumococcal
  • staphylococcal
  • tuberculous

The most common form of meningitis

This is caused by meningococcal bacteria which can cause meningitis, septicaemia or both.

Septicaemia is the more life threatening form of the disease and is more dangerous when there are no signs of meningitis.

Babies are at a higher risk of bacterial meningitis than any other age group. They can fall ill with all of the main types of meningitis and septicaemia, including:

  • meningococcal
  • pneumococcal, and
  •  Hib

Bacterial forms that mostly, but not exclusively, affect newborn babies are:

  • Group B Streptococcal (GBS)
  • E. Coli
  • Listeria

 Symptoms of meningitis

Babies and young children under five years of age

This age group are most at risk and may develop some of the following symptoms, in any order:

  • high fever
  • cold hands and feet
  • vomiting
  • refusing to feed
  • agitation and reusing to be picked up
  • drowsiness, floppy and unresponsive
  • rapid breathing   
  • unusual high-pitched or moaning cry
  • pale, blotchy skin,
  • red rash
  • tense, bulging soft spot on the top of the head, known as the ‘fontanelle’
  • stiff neck and sensitivity to light
  • convulsions or seizures

Older children, teenagers and adults

For this age group,  additional symptoms also include:

  • difficulty waking up
  • confusion and irritability
  • severe muscle pain
  • severe headache
  • stiff neck

Diagnosing meningitis 

The glass test – a quick first test you can carry out immediately at home

If a rash appears, press the side of a clear glass firmly against the skin.  A rash that doesn’t fade under pressure could be a sign of meningococcal septicaemia.

A rash that doesn’t fade under pressure might first appear as a few small spots or “pin pricks” on any part of the body. The condition often spreads rapidly and begins to look like fresh bruising as blood leaks into tissue under the skin.

It is vital to get immediate medical help if you or anyone in your family show any symptoms of meningitis.

Clinical testing for meningitis

If a patient is suspected of having meningitis, it is important to perform several key clinical tests to help confirm a diagnosis.

  • Lumbar puncture – also called a “spinal tap”, in which spinal fluid is collected for testing.
  • CT scan of the head
  • Chest X-ray
  • Blood culture analysis

Why misdiagnosis occurs

Another sickness or condition is thought to be the cause, often including:

  • Shaken Baby Syndrome
  • Swine Flu
  • Pneumonia
  • Flu
  • Jaundice

More than one sickness at a time - a child who developed a cold or flu around the same time as the meningitis bacteria entered the brain should show the signs of the less dangerous sickness  As a result,  other symptoms can be overlooked.

Diagnosed as a more serious condition like cancer – treatment for cancer of the brain does not affect the development of meningitis.

How is meningitis treated?

The treatment for severe bacterial meningitis will frequently require hospital treatment.

A variety of regular treatments will include:

  • Antibiotics 
  • Anti-convulsants
  • Corticosteroids
  • Paracetemol
  • Oxygen therapy
  • Fluid control
  • Blood tests 
  • Sedatives

Complications of bacterial meningitis include:

  • Brain damage
  • Build-up of fluid between the skull and brain
  • Hearing loss
  • Seizures

Permanent brain damage or even death can result if a diagnosis is delayed and brain swelling persists.

Further consequences of bacterial meningitis are:

  • Brain damage, itself causing epilepsy, loss of memory or cognitive impairment, deafness.
  • Loss of limb/s - if accompanied by septicaemia.

How Your Legal Friend can help you

Complications from meningitis may be caused by a delayed or inaccurate diagnosis made by a doctor or another healthcare practitioner.

For a medical negligence case to be successful, you have to prove that:

  • The doctor, surgeon or hospital was in breach of the duty of care they owed to their patient.
  • The care received fell below the standard that could “reasonably be expected” from a specialist in the field.
  • The lack of care led directly to the injury or harm which was a “reasonably foreseeable consequence” of the actions or omissions of the doctor or other person providing the treatment.

As experienced clinical negligence specialists, we know that you and your family may feel shocked and devastated that you may not have received the necessary, appropriate standard of care or treatment. We also know that families need to find answers as to why the healthcare system has failed them at their time of greatest need.

There can often be an enormous emotional hurdle to overcome before even taking the decision to seek legal advice. You also need to have confidence that your clinical negligence specialists possess the in-depth knowledge and experience of both the complex legal and medical issues involved in securing a successful claim.

However, from the first time we discuss your case, our experienced medical negligence solicitors will treat you with the highest degree of sympathetic and sensitive understanding and provide you with the expert guidance you need.

We are committed to ensuring we properly investigate what went wrong and why, and to make those responsible for their failure to provide you with an appropriate standard of care account for their actions..  If we can prove your case, we will secure the maximum compensation for you including loss of earnings, rehabilitation costs, therapy, support, care and specialist equipment, so that your current and future medical treatment and care needs are properly met.