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Skeletal lesions following meningococcemia and disseminated intravascular coagulation. A recognizable skeletal
Abstract:
Partial destruction of the right humeral and right femoral head were discovered in a 30-month-old girl, two years after her recovery from meningococcal septicemia and disseminated intravascular coagulation (DIC). Additional findings were symmetrical epiphyseal-metaphyseal lesions of the lower femora and upper and lower tibiae. The combined skeletal lesions seem to be characteristic sequelae of infantile meningococcemia complicated by DIC. Since this condition is no longer uniformly fatal, the characteristic skeletal dystrophy will be encountered more frequently and should be recognized by radiologists, pediatricians, and orthopedists. The features shared by our patient and the seven previously published cases are presented.
Insights
Infantile meningococcemia with disseminated intravascular coagulation (DIC) can cause characteristic skeletal dystrophy. This condition, involving bone lesions, is increasingly recognized as survivors of meningococcal septicemia are more common.
Area of Science:
- Pediatric Orthopedics
- Pediatric Infectious Diseases
- Pediatric Radiology
Background:
- Meningococcal septicemia, a severe bacterial infection, can lead to serious complications like disseminated intravascular coagulation (DIC).
- While historically associated with high mortality, advancements in treatment have increased survival rates for infantile meningococcemia.
Observation:
- A 30-month-old girl presented with partial destruction of the right humeral and femoral heads.
- Skeletal imaging revealed symmetrical epiphyseal-metaphyseal lesions in the lower femora and tibiae.
- These bone abnormalities were noted two years post-recovery from meningococcal septicemia and DIC.
Findings:
- The observed skeletal lesions are characteristic sequelae of infantile meningococcemia complicated by DIC.
- This specific pattern of bone dystrophy has been documented in previously reported cases.
Implications:
- Recognizing this skeletal dystrophy is crucial for radiologists, pediatricians, and orthopedists as more children survive meningococcal infections.
- Early identification and understanding of these sequelae can aid in managing long-term orthopedic complications in affected children.