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[Incidence, clinical, forms and complications of meningococcal infections (author's transl)]
Abstract:
Eighty four cases of meningococcal infections are reviewed. Fifty seven cases presented themselfs as meningococcal meningitis, twelve cases as sepsis with moderate hypotension and 15 cases were sepsis with septic shock. A brief course of the disease, shock, echymosis, absence of meningeal signs, leucopenia and intravascular coagulation were findings more frequent in the group of patients with hiperacute sepsis, whereas other signs as fever, headaches, vomiting and petechiae were present with equal frequency in the three groups. N. meningitis was isolated in 73% of the cases. Shock (18.85%) and intravascular coagulation (12%) were the complications more frequently found, followed by convulsions (4.81%), arthritis (4.81%), skin necrosis (4.81%), subdural efusion (3.57%), cerebral palsy (3.40%), thrombophlebitis (1.20%), recurrence (1.20%), inapropiate antidiuretic hormone secretion (1.20%) and subaracnoideal hemorrage (1.20%). The overall mortality was 10.70% and 60% of the patients which initially presented with shock and intravascular coagulation died. Autopsy findings included wide spred hemorragic lesions and intravascular thrombi in skin, mucous membranes and viscera. Adrenal hemorrhage was present in five of the six cases studied.
Insights
Meningococcal infections can rapidly progress to severe sepsis and shock. Early recognition of symptoms like shock and disseminated intravascular coagulation is crucial for improving outcomes in these serious infections.
Area of Science:
- Infectious Diseases
- Pediatrics
- Critical Care Medicine
Background:
- Meningococcal infections encompass meningitis and sepsis.
- Sepsis can present with varying severity, including moderate hypotension and septic shock.
- Neisseria meningitidis is a primary causative agent.
Purpose of the Study:
- To review cases of meningococcal infections.
- To identify clinical features differentiating disease severity.
- To analyze complications and outcomes.
Main Methods:
- Retrospective review of 84 cases of meningococcal infections.
- Classification of cases into meningitis, sepsis with hypotension, and sepsis with septic shock.
- Analysis of clinical signs, laboratory findings, complications, and mortality.
Main Results:
- Fifty-seven cases were meningitis, 12 sepsis with hypotension, and 15 sepsis with septic shock.
- Hyperacute sepsis was associated with rapid disease course, shock, ecchymosis, absence of meningeal signs, leukopenia, and intravascular coagulation.
- Neisseria meningitidis was isolated in 73% of cases. Overall mortality was 10.70%, with 60% mortality in patients presenting with shock and intravascular coagulation.
Conclusions:
- Clinical presentation varies significantly among meningococcal infection types.
- Rapidly progressive sepsis with shock and intravascular coagulation indicates a poor prognosis.
- Autopsy findings reveal widespread hemorrhagic lesions and intravascular thrombi, including adrenal hemorrhage.