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Retinal hemorrhages in meningococcal septicemia
Subramanian Dinakaran1, Tin K J Chan, Neil K Rogers
1Department of Ophthalmology, Royal Hallamshire Hospital, Sheffield, England.
Insights
Retinal hemorrhages are common in children with meningococcal septicemia, occurring in 42% of cases. Ophthalmic evaluation is crucial for assessing this serious condition.
Area of Science:
- Ophthalmology
- Pediatrics
- Infectious Diseases
Background:
- Meningococcal septicemia frequently causes coagulopathy and bleeding tendencies.
- Retinal hemorrhages are a potential complication of severe infections.
Purpose of the Study:
- To determine the incidence of retinal hemorrhages in children diagnosed with meningococcal septicemia.
Main Methods:
- Prospective study of children admitted with meningococcal septicemia.
- Confirmed diagnosis via blood culture or PCR.
- Ocular examinations including funduscopy and coagulation status assessment.
Main Results:
- Twelve children (mean age 4.5 years) were included; all had coagulopathy.
- Retinal hemorrhages observed in 5 children (42%).
- Group C meningococcus linked to hemorrhages and fatal outcomes (3 deaths).
Conclusions:
- Retinal hemorrhage is a frequent finding in pediatric meningococcal septicemia.
- Ophthalmic evaluation should be standard in assessing these patients.
- Including retinal hemorrhage in future studies may clarify its prognostic significance.
Purpose:
Meningococcal septicemia is associated with coagulopathy and hemorrhagic tendency. We carried out this study to determine the incidence of retinal hemorrhages in meningococcal septicemia.
Methods:
This was a prospective study involving all children admitted to the Sheffield Children's Hospital, Sheffield, England, with a diagnosis of meningococcal septicemia. Confirmation of meningococcal infection was by blood culture or DNA analysis using polymerase chain reaction. The children underwent ocular examination including dilated fundus examination by direct and indirect ophthalmoscopy. Details of their coagulation status were also obtained.
Results:
Twelve children (mean age, 4.5 years) with a confirmed diagnosis of meningococcal septicemia were included. All children had coagulopathy. Retinal hemorrhages were found in 5 children (42%). The disease was fatal in 3 children. Group C meningococcus was responsible for the infection in all those with retinal hemorrhages and those with fatal outcome.
Conclusions:
Retinal hemorrhage is a common feature in meningococcal septicemia. Ophthalmic evaluation should be part of the assessment of children with meningococcal septicemia. Future studies on meningococcal disease should include retinal hemorrhage as another parameter in the assessment. This should help us to understand the role of retinal hemorrhage in the prognosis of this serious disease.