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Cutaneous Involvement in Acute Meningococcemia (Study of an Epidemic in Delhi)

V Ramesh, Siddharth Ramji, Kumar Sunil Sehgal

    Indian Journal of Dermatology, Venereology and Leprology
    |February 2, 2017
    PubMed

    Insights

    Meningococcus group A infection caused skin lesions in 88% of children during a Delhi epidemic. Purpuric lesions were most common, with severe vascular damage and gangrene developing later in some cases.

    Area of Science:

    • Pediatrics
    • Infectious Diseases
    • Dermatology

    Background:

    • An epidemic of meningococcus group A infection occurred in Delhi.
    • Skin manifestations are a notable feature of meningococcal disease.

    Purpose of the Study:

    • To describe the clinical presentation and histopathology of skin lesions in children during a meningococcus group A epidemic.

    Main Methods:

    • Observational study of 34 children with skin lesions during the epidemic.
    • Clinical examination and histopathological analysis of skin biopsy specimens.

    Main Results:

    • Eighty-eight percent of children (30/34) presented with skin lesions.
    • Purpuric lesions (60%) were the most frequent type, followed by maculo-papular (26.67%) and faint pink macules (13.33%).
    • Conjunctival involvement occurred in 3 children. Ulcers and gangrene developed after 7 days in one child, with severe vascular damage noted on histopathology. Extremity gangrene occurred during recovery.

    Conclusions:

    • Meningococcus group A infection in children can present with diverse skin lesions.
    • The progression from early lesions to severe vascular damage and gangrene highlights the potential severity of the infection.

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