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[Extra-meningeal meningococcal infection: report of 14 cases]

S Guignard1, V Manceron, J Pouchot

  • 1Service de médecine interne V, hôpital Louis-Mourier, 178, rue des Renouillers, 92700 Colombes, France. sandra.guignard@lmr.ap-hop-paris.fr

La Revue De Medecine Interne
|January 23, 2004
PubMed
Abstract

Insights

Adults with extra-meningeal meningococcal infection often have immunodeficiency and severe disease, unlike children who typically present with fever and recover well. This highlights distinct clinical presentations and outcomes for meningococcal disease in different age groups.

Area of Science:

  • Infectious Diseases
  • Pediatrics
  • Immunology

Context:

  • Meningococcal infections, caused by Neisseria meningitidis, can manifest as either meningitis or extra-meningeal disease.
  • Understanding age-specific presentations and outcomes is crucial for effective clinical management.
  • This study examines a cohort of patients admitted to a university hospital over a 16-year period.

Purpose:

  • To compare the clinical presentations, severity, and outcomes of extra-meningeal Neisseria meningitidis infections in adults and children.
  • To identify key differences in disease manifestation and patient characteristics between adult and pediatric populations.

Summary:

  • The study included 55 patients with meningococcal infection, 14 of whom had extra-meningeal disease (9 adults, 5 children).
  • Adults with extra-meningeal infections were predominantly immunodeficient, experienced diverse septic locations, required longer hospitalizations (mean 47 days), and had a higher risk of intensive care unit (ICU) admission and mortality (2 deaths).
  • In contrast, children (all under 36 months) primarily presented with fever, were rarely immunodeficient, had shorter hospital stays (mean 4 days), and all recovered fully with antibiotic treatment without ICU admission.

Impact:

  • The findings underscore the significant differences in the clinical spectrum and prognosis of extra-meningeal meningococcal infections between adults and children.
  • Adults with extra-meningeal meningococcal disease represent a vulnerable population requiring vigilant monitoring and potentially different therapeutic strategies.
  • Pediatric cases of extra-meningeal meningococcal infection, while less common, appear to have a more favorable prognosis, emphasizing the importance of early diagnosis and prompt antibiotic therapy.

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