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Complications and sequelae of meningococcal infections in children
Abstract:
Eight-six children with meningococcal meningitis or bacteremia were evaluated prospectively between 1977 and 1979 to determine the incidence of complications and features predictive of their development. The majority (83%) of these infections were caused by serogroup B strains. Twenty-seven percent of survivors experienced one or more suppurative, allergic, or neurologic complications. Hearing loss, noted in 9% of children, occurred significantly more often in patients with admission leukocytosis or leukopenia, or with CSF leukocytosis greater than 10,000/mm3 than in those with an uncomplicated course (P less than 0.01). Ten percent of survivors developed allergic complications manifested as cutaneous vasculitis or arthritis with onset five to eight days after admission. Shock, purpuric skin lesions, and fever persisting longer than five days occurred significantly more often in these children than in those who developed hearing loss or those with an uncomplicated course (P less than 0.05). Resolution of allergic complications occurred within 14 days of their onset. Compared to Neisseria meningitidis groups A and C, group B strains appear to be intermediate in their potential for allergic complications associated with childhood infection.
Insights
Meningococcal meningitis complications in children, particularly serogroup B strains, can lead to hearing loss and allergic reactions. Early detection of specific blood and CSF markers may predict these adverse outcomes.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Meningococcal disease, including meningitis and bacteremia, poses significant risks to children.
- Serogroup B strains were the predominant cause of infection in the studied cohort.
- Understanding complication incidence and predictive features is crucial for patient management.
Purpose of the Study:
- To determine the incidence of complications in children with meningococcal infections.
- To identify features that predict the development of these complications.
- To compare the complication potential of different Neisseria meningitidis serogroups.
Main Methods:
- Prospective evaluation of 86 children with meningococcal meningitis or bacteremia between 1977-1979.
- Analysis of suppurative, allergic, and neurologic complications in survivors.
- Statistical comparison of features associated with complications versus uncomplicated cases.
Main Results:
- 27% of survivors experienced at least one complication.
- Hearing loss occurred in 9% of children, associated with specific white blood cell counts.
- Allergic complications (vasculitis, arthritis) occurred in 10% of survivors, linked to shock and persistent fever.
Conclusions:
- Serogroup B strains show intermediate potential for allergic complications compared to groups A and C.
- Admission leukocytosis/leukopenia and high CSF leukocytosis are predictive of hearing loss.
- Specific clinical signs predict allergic complications, which typically resolve within 14 days.