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Severe meningococcal septicaemia associated with splenic rupture
M D Buist1, R G Power, S R Keeley
1Intensive Care Unit, Adelaide Children's Hospital, North Adelaide, SA.
Objective:
To present the first report of ruptured spleen associated with meningococcal septicaemia.
Clinical Features:
A 13-year-old girl presented with an acute abdomen and clinical signs of meningococcal septicaemia. Features of her illness placed her in a high mortality group.
Intervention And Outcome:
She required cardiovascular and respiratory support in the Intensive Care Unit. Failure to initially identify the organism led to percutaneous fine-needle aspiration of fluid in the lesser sac. A laparotomy revealed free intraperitoneal blood and a ruptured spleen. During the course of her illness she was given penicillin and methylprednisolone, and required haemodialysis. She made a complete recovery.
Conclusion:
Ruptured spleen does occur with severe meningococcaemia, and may complicate management.
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