Doctors discover 'red flags' for serious infections

Rapid breathing, a bluish tinge to the skin, and a rash that doesn’t fade when pressed are all warning signs that could indicate serious infections in children, a new study shows. Parents and doctors are also justified in relying on their instincts, according to the research, as parental concern or a doctor’s hunch are reliable indicators of a more serious illness.

What do we know already?

Serious infections, such as meningitis, can be life-threatening, but are often difficult to distinguish from common, milder illnesses. The average child will see a doctor four times before the age of one with an infection, but most of the time there won’t be anything seriously wrong.

Severe infections can have dangerous consequences, so it’s important for doctors to be able to tell them apart from the more minor illnesses that children pick up. By analysing 30 previous studies on the topic, researchers have come up with a list of ‘red flag’ symptoms that are warning signs of a severe infection.

What does the new study say?

In children, warning signs of a serious infection include:

*A blue or purplish tinge to the child’s skin, often around the fingernails or the mouth.

*Rapid breathing.

*Poor blood flow to the hands and feet. Your child’s hands or feet might feel much colder than usual. You can also test blood flow by pressing one of the child’s fingernails until it turns white, and seeing how long it takes to turn pink again. The exact time will depend on lots of things, like the temperature of the room, but under 2 seconds is usually considered normal.

*A rash caused by broken blood vessels under the skin. Some rashes will go away if you press them, but this kind won’t. You can check by rolling a drinking glass over the rash.

*Drowsiness or loss of consciousness.

*Having seizures (fits).

*A temperature of over 40°C. (Normal body temperature is around 37°C.)

Research also shows that if parents are very worried, or a doctor has a hunch that something is seriously wrong, it’s a good idea to trust these instincts. One study found that concern from parents or a doctor was linked to a higher chance of the child’s illness being serious.

How reliable are the findings?

The new study is a round-up of all the research that’s been done so far. A slight problem is that most studies have looked at children in emergency departments, where children are more likely to be seriously ill than in a GP surgery.

Where does the study come from?

The study was done by researchers from the University of Oxford and the University of Leuven in Belgium. It appeared in The Lancet medical journal.

What does this mean for you?

The studies give you some guidelines about warning signs to be aware of.

What should you do now?

If you’re ever worried about your child’s health, it’s always safest to get medical advice. Some children may have serious infections without any of the warning signs above, so don’t put off getting help just because your child doesn’t have these signs.