Meningitis rash - the glass test

A rash that does not fade under pressure is a sign of meningococcal septicaemia. It is normally referred to as the meningitis rash.

If someone is ill and getting worse do not wait for a rash, it can appear late or not at all. A fever with spots or a rash that does not fade under pressure is a medical emergency.

How to do the glass test: 

• Take an ordinary clear glass (or plastic) tumbler

• Place it on the skin next to the spots/rash

• Roll it onto the spots/rash, applying firm pressure. Note that the normal skin under the glass goes white as the blood is pushed out of the tiny surface blood vessels

• If the spots fade when the glass is rolled over them, the rash may not be serious, but keep checking, it can develop into a rash that does not fade

• If spots/rash doesn’t fade, it is a non-blanching rash, and needs urgent medical attention

  Remember though: Don't wait for a rash, it won't always appear or may appear late. Trust your instincts.

• Meningitis and septicaemia often happen together. Be aware of all signs and symptoms.
• If someone is ill and getting worse do not wait for a rash, it can appear late or not at all.
• A fever with spots or a rash that does not fade under pressure is a medical emergency.
• The spots or rash may fade at first, keep checking.
• The rash is more difficult to see on dark skin. Look on paler areas of the skin and under the eyelids

What is the meningitis rash?

As meningicoccal bacteria multiply rapidly in the bloodstream, they begin to release endotoxins (poisons) from their outer coating. The body’s natural defences have little effect on these poisons and eventually blood vessels become damaged.

As septicaemia advances, it affects the whole body and can cause organ damage or failure. The rash associated with septicaemia is caused by blood leaking into the tissues under the skin.

It’s important to know that septicaemia can also cause other more specific symptoms to look out for (as well as the rash):

• Fever with cold hands and feet
• Joint or muscle pain
• Rapid breathing
• Stomach cramps and diarrhoea

What do I do if I suspect meningitis or septicaemia?

If you suspect meningitis or septicaemia, get medical help immediately. You can:

• Call NHS Direct/NHS 24 or your GP.
• Go to your nearest accident and emergency department.
• Dial 999 for an ambulance.
• Describe the symptoms carefully and say that you think it could be meningitis or septicaemia
• Early diagnosis can be difficult. If you have had advice and are still worried, get medical help again.
• Trust your instincts.

Did you know?

• It is a common misconception that a meningitis rash appears in every case of meningitis. This is not true. If someone has meningitis but not septicaemia, they will not have a rash that does not fade, but they can still be seriously unwell. Never wait for a rash.
• Meningitis is the disease parents fear the most. And with 50% of all cases occurring in children under five, it’s easy to see why. We encourage parents to familiarise themselves with the symptoms, so that they can spot any of the tell-tale signs straight away and get urgent medical help.
  If you are worried about the symptoms of meningitis and spotting them in time, let us help you by sending you our free symptoms card.

Email us at helpline@meningitis-trust.org or call our nurses on 0808 80 10 388 for free to request one.

We also provide free meningitis symptoms mobile apps for you to download onto your phone.