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Study of skin lesions in 221 patients of meningococcal disease
Abstract:
During a meningococcal outbreak, 221 patients were studied. A skin rash was present in 78 (35.3%) patients. Twenty one (11.3%) patients had a frankly purpuric rash, involving mainly the extremities and the remaining had a generalised macular or petechial lesions. Extensive purpuric lesions, involving mainly the extremities were associated with disseminated intravascular coagulation (DIC), shock and a fatal outcome. This peripherally distributed rash may be used as a clinical substitute for the laboratory tests that confirm DIC.
Insights
During a meningococcal outbreak, a specific skin rash pattern was observed. Extensive purpuric lesions on extremities indicated disseminated intravascular coagulation (DIC), shock, and fatality, potentially serving as a clinical indicator.
Area of Science:
- Infectious Diseases
- Dermatology
- Critical Care Medicine
Background:
- Meningococcal disease outbreaks pose significant public health challenges.
- Early identification of severe meningococcal disease complications is crucial for timely intervention.
- Skin manifestations in meningococcal infections can indicate systemic involvement and prognosis.
Purpose of the Study:
- To investigate the characteristics of skin rash in patients during a meningococcal outbreak.
- To determine the association between specific rash types and severe complications like disseminated intravascular coagulation (DIC).
- To evaluate the potential of peripheral purpuric rash as a clinical predictor of DIC.
Main Methods:
- Retrospective analysis of 221 patients admitted during a meningococcal outbreak.
- Clinical assessment of skin rash characteristics, including type, distribution, and morphology.
- Correlation of rash patterns with laboratory confirmation of disseminated intravascular coagulation (DIC), shock, and patient outcomes.
Main Results:
- A skin rash was present in 35.3% of patients.
- Frankly purpuric rash, predominantly on extremities, was observed in 11.3% of patients.
- Extensive, peripherally distributed purpuric lesions were significantly associated with DIC, shock, and fatal outcomes.
Conclusions:
- The presence of extensive, peripherally distributed purpuric rash in meningococcal disease is a strong indicator of disseminated intravascular coagulation (DIC).
- This specific rash pattern may serve as a valuable clinical sign, potentially reducing reliance on laboratory tests for diagnosing DIC in outbreak settings.
- Early recognition of this dermatological sign can facilitate prompt management of severe meningococcal disease.