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Clinical phenotypes and household structure in pediatric invasive meningococcal disease: A retrospective cohort study

Kubra Boydag Guvenc1, Cansu Durak1, Nihal Akcay2

  • 1Ministry of Health Sancaktepe Sehit Prof Dr Ilhan Varank Training and Research Hospital, Department of Pediatric Intensive Care, Istanbul, Turkey, Istanbul.

Klinische Padiatrie
|August 5, 2026
PubMed

Insights

Meningococcal sepsis in children presents more severe symptoms and higher mortality than meningitis. Early identification of sepsis phenotype aids critical care management for invasive meningococcal disease.

Area of Science:

  • Pediatric critical care medicine
  • Infectious diseases
  • Clinical epidemiology

Background:

  • Invasive meningococcal disease (IMD) has varied presentations, with phenotype-specific severity in critically ill children not fully understood.
  • Differences in clinical phenotypes of IMD can impact disease severity and patient outcomes.
  • Understanding these differences is crucial for effective management in pediatric intensive care units.

Purpose of the Study:

  • To evaluate the association between clinical phenotypes of IMD and early disease severity.
  • To assess the impact of different IMD phenotypes on outcomes in critically ill children.
  • To inform risk stratification and management strategies for pediatric IMD.

Main Methods:

  • Retrospective cohort study of 42 children with IMD admitted to a tertiary pediatric intensive care unit (PICU) from 2006-2020.
  • Patients classified into two groups: meningococcal sepsis without meningitis and meningococcal meningitis.
  • Disease severity assessed using Pediatric Risk of Mortality III (PRISM III) score; demographic, clinical, and household data analyzed.

Main Results:

  • Meningococcal sepsis without meningitis occurred in 54.8% of patients, associated with higher PRISM III scores (median 20 vs. 11), increased lactate, lower platelets, and more organ support.
  • The sepsis phenotype showed significantly higher mortality (34.8% vs. 5.3%, p=0.023) compared to the meningitis phenotype.
  • Extended family living was more common in the meningitis group (26.3% vs. 4.3%, p=0.043); Serogroup B was predominant.

Conclusions:

  • Meningococcal sepsis without meningitis is linked to greater early severity and higher mortality in a PICU cohort compared to meningococcal meningitis.
  • Phenotype-based early risk assessment can aid in managing critically ill children with IMD.
  • Household structure findings require further investigation.
Abstract

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