Meningococcal meningitis without rash

Meningococcal meningitis is a major health problem in the developing world. The clinical features may vary from transient fever and bacteraemia to fulminant disease with death ensuing within hours of the onset of clinical symptoms. The classical and clinical manifestations of meningococcal disease have been well described, but atypical presentations if unrecognised, may lead to a delay in treatment and fatal outcome. Here, we report a case of atypical presentation of meningococcal meningitis without classical rash, which was diagnosed and managed successfully.