Related Experiment Videos
Meningococcal infections in children: a review of 100 cases
V K Wong1, W Hitchcock, W H Mason
1Department of Pediatrics, Children's Hospital of Los Angeles, CA 90054-0700.
Insights
Meningococcal infections in children can be severe, even without typical skin lesions or abnormal cerebrospinal fluid. Early recognition of poor prognostic signs is crucial for improving outcomes in pediatric Neisseria meningitidis cases.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Meningococcal infections, caused by Neisseria meningitidis, are a significant cause of childhood illness and death.
- Clinical presentations vary widely, from simple fever to life-threatening septic shock and purpura fulminans.
Purpose of the Study:
- To review clinical manifestations and outcomes of meningococcal infections in children.
- To identify prognostic indicators for severe disease and mortality.
Main Methods:
- Retrospective review of 100 children diagnosed with meningococcal infection between January 1985 and February 1988.
- Analysis of clinical data, laboratory results, and patient outcomes.
Main Results:
- Twenty-nine percent of children lacked characteristic skin lesions.
- Six of 55 meningitis patients had normal initial cerebrospinal fluid (CSF) findings but positive CSF cultures.
- The overall case fatality rate was 10%.
Conclusions:
- Meningococcal infections should be suspected even without skin lesions or CSF abnormalities.
- Hypothermia, seizures, shock, low white blood cell count, low platelet count, and purpura fulminans are poor prognostic indicators.
Abstract:
One hundred children with meningococcal infection diagnosed from January 1, 1985, to February 29, 1988, were reviewed. Clinical manifestations ranged from fever alone to fulminant septic shock with purpura fulminans. Twenty-nine percent of the children presented without skin lesions. Of the 55 patients with meningitis, 6 lacked cerebrospinal fluid abnormalities on initial lumbar puncture but cerebrospinal fluid cultures were positive. An overall case fatality rate of 10% was noted with the following poor prognostic indicators identified: hypothermia; seizures or shock on presentation; a total peripheral white blood cell count less than 5000/mm3; a platelet count less than 100,000/mm3; and the development of purpura fulminans. Meningococcal infections remain an important cause of morbidity and mortality in children. Infections caused by Neisseria meningitidis (including meningitis) should be considered even in the absence of skin lesions or cerebrospinal fluid abnormalities.