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Related Experiment Videos

Prognostic factors in acute meningococcaemia.

L S Lewis

    Archives of Disease in Childhood
    |January 1, 1979
    PubMed
    Summary

    Severe meningococcaemia in Nigerian children had a high mortality rate of 43%. Prognosis depended on clinical signs like coma and shock, and initial serum antigen titre, guiding potential new treatments.

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    Area of Science:

    • Pediatrics
    • Infectious Diseases
    • Epidemiology

    Background:

    • Meningococcal disease, particularly group A, poses a significant public health threat during epidemics.
    • Acute meningococcaemia without meningitis presents a distinct clinical challenge with potentially high mortality.

    Purpose of the Study:

    • To investigate the clinical features, outcomes, and potential prognostic markers in Nigerian children with acute meningococcaemia during an epidemic.

    Main Methods:

    • A cohort of 47 Nigerian children with acute meningococcaemia (without meningitis) was studied.
    • Clinical presentation (coma, shock), serum antigen titre, endotoxin, cortisol, and fibrin degradation products were assessed.
    • Mortality rates were compared between patient groups and the overall epidemic.

    Main Results:

    • The mortality rate for studied children was 43%, significantly higher than the epidemic average of 8%.
    • Patients presenting with both coma and shock had a 93% mortality rate, while those without these symptoms had a 6% rate.
    • Initial serum antigen titre correlated with outcome, unlike serum endotoxin, cortisol, or fibrin degradation products.
    • Chloramphenicol and penicillin demonstrated similar efficacy.

    Conclusions:

    • Clinical presentation (coma, shock) and initial serum antigen titre are critical prognostic indicators for acute meningococcaemia in children.
    • A predictive model incorporating these factors could aid in assessing disease severity and evaluating novel therapeutic interventions.

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