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[Morphological characteristics of meningococcemia in children]
Abstract:
Observations were conducted over 8 children aged 5 months to 3 years and 2 months, in whom the disease developed acutely and was accompanied by collapse. Death occurred within the first 12--36 hours from the onset of the disease. Morphologically, there were revealed haemorrhagic rash, initial phenomena of serous-purulent meningitis, clear-cut disorders of the microcirculation (stasis, thrombosis) in the skin, lungs, myocardium, kidneys. The cause of early death of the children with meningoccaemia turned out to be the Waterhouse-Friderichsen syndrome, the morphological manifestations of the latter being bilateral haemorrhages into the adrenals. In the kidneys capillarothrombosis may develop, which is in accord with the picture of the Sanarelli-Schwartzmann phenomenon, and may lead to the development of acute renal insufficiency with formation of cortical necroses of the kidneys.
Insights
Waterhouse-Friderichsen syndrome caused rapid death in 8 children with meningococcemia. This pediatric condition, marked by adrenal hemorrhages and microcirculation collapse, led to fatalities within 36 hours.
Area of Science:
- Pediatric Pathology
- Infectious Diseases
- Microcirculation Disorders
Context:
- Meningococcemia is a severe bacterial infection.
- Acute collapse and rapid death are observed in affected children.
- Morphological changes indicate widespread microvascular compromise.
Purpose:
- To investigate the pathological findings in children with fatal meningococcemia.
- To identify the cause of early death in pediatric meningococcemia cases.
- To correlate clinical presentation with specific morphological manifestations.
Summary:
- Observations in 8 children (5 months to 3 years) with acute meningococcemia revealed fatal collapse within 12-36 hours.
- Morphological findings included hemorrhagic rash, meningitis, and severe microcirculation disorders (stasis, thrombosis) in skin, lungs, myocardium, and kidneys.
- The cause of death was identified as Waterhouse-Friderichsen syndrome, characterized by bilateral adrenal hemorrhages. Kidney capillarothrombosis, consistent with the Sanarelli-Schwartzmann phenomenon, was also noted, potentially causing acute renal insufficiency and cortical necrosis.
Impact:
- Highlights the critical role of Waterhouse-Friderichsen syndrome in pediatric meningococcemia mortality.
- Provides detailed morphological evidence of microcirculatory failure and its systemic consequences.
- Emphasizes the potential for renal complications, including acute renal insufficiency and cortical necrosis, in severe meningococcemia.