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[Meningococcal disease: clinicopathological correlation].

Nádia Stella-Silvaa1, Solange A Oliveiraa, Keyla B Feldman-Marzochib

  • 1Antônio Pedro University Hospital. Federal Fluminense University and Evandro Chagas Clinical Research Institute - IPEC/FIOCRUZ. Rio de Janeiro. Brazil. nadia@ipec.fiocruz.br

Enfermedades Infecciosas Y Microbiologia Clinica
|December 4, 2003
PubMed
Summary

This study found a significant correlation between clinical and pathological diagnoses of meningococcal disease (MD). However, histopathology couldn't distinguish between septicemic MD and MD with meningitis/septicemia, suggesting severity variations.

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Area of Science:

  • Pathology
  • Infectious Diseases
  • Clinical Medicine

Context:

  • Clinicopathological correlation studies for meningococcal disease (MD) are limited.
  • Understanding these correlations can clarify obscure clinical presentations of MD.

Purpose:

  • To analyze the clinicopathological correlation in 42 necropsies of patients clinically diagnosed with meningococcal disease.
  • To evaluate the agreement between histopathological findings and clinical diagnoses across three forms of MD: septicemic (MD-S), meningitis and septicemia (MD-MS), and meningitis/meningoencephalitis alone (MD-M).

Summary:

  • 81% of cases met confirmatory clinical criteria for MD, with 56% occurring in individuals 14 years or younger.
  • Major causes of death included multiple organ failure (59%), cerebral edema (29%), and myocarditis (12%).

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  • High correlations were observed between septic shock and adrenal hemorrhage (77%), and respiratory failure and pulmonary alterations (77%). Myocarditis and fibrin thrombi were prevalent in MD-S and MD-MS, while adrenal hemorrhage and enteritis were more common in MD-S.
  • Significant correlation (P <.0001) was found between clinical and pathological diagnoses for MD forms. However, histopathology did not differentiate MD-S from MD-MS, indicating they represent severity variations.

    • Impact:

    • This research highlights the importance of clinicopathological correlation in diagnosing meningococcal disease.
    • Findings can aid in understanding disease mechanisms and improving diagnostic accuracy, particularly in differentiating disease severity.