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The changing presentations of meningococcal disease

F A Riordan1, O Marzouk, A P Thomson

  • 1Institute of Child Health, Alder Hey Children's Hospital, Liverpool, UK.

European Journal of Pediatrics
|June 1, 1995
PubMed
Abstract

Insights

Meningococcal disease (MCD) is increasingly presenting as septicaemia alone, not just meningitis. This life-threatening presentation, characterized by a petechial rash, affects nearly one in five children with septicaemia alone.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Epidemiology

Background:

  • Meningococcal disease (MCD) encompasses meningitis, meningitis with septicaemia, and septicaemia alone.
  • Previous understanding often equated MCD primarily with meningitis.

Purpose of the Study:

  • To investigate the trend in the proportion of MCD cases presenting as septicaemia alone over a 17-year period.
  • To analyze mortality rates associated with different presentations of MCD.

Main Methods:

  • Retrospective analysis of 449 pediatric MCD admissions between 1977 and 1993.
  • Comparison of MCD presentation proportions and mortality rates across different time intervals within the study period.

Main Results:

  • The proportion of MCD cases presenting as septicaemia alone significantly increased from 7% (1977-1985) to 36% (1990-1993).
  • Mortality was highest in children with septicaemia alone (19%).
  • Overall MCD mortality did not change significantly despite the rise in septicaemia cases.

Conclusions:

  • Meningococcal disease (MCD) should be recognized as frequently presenting with septicaemia alone (33% of cases).
  • Septicaemia alone is a critical, life-threatening presentation of MCD, with nearly 20% mortality.
  • Public health information on MCD should emphasize septicaemia, particularly the presence of a petechial rash.

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