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Fatal meningococcal disease in childhood: an autopsy study of 86 cases
1Department of Pathology, Red Cross Children's Hospital, Rondebosch, South Africa.
Abstract:
A retrospective study of the pathology in 86 consecutive autopsies of fatal meningococcal infection in children, performed at the Red Cross War Memorial Children's Hospital during the 19-year period from 1973 to 1991, was undertaken. The most prominent pathological changes found at autopsy were those of an overwhelming bacterial infection with evidence of disseminated intravascular coagulopathy in many organs of the body. The skin, adrenal glands and central nervous system were most commonly involved. Acute myocarditis occurred in 23 cases (27%) and was diagnosed almost exclusively histologically. In only one case was it diagnosed clinically. In addition, the nutritional status and the morphological expression of immune reactivity of our hospital population was better than expected.
Insights
Fatal meningococcal infection in children often shows widespread bacterial infection and disseminated intravascular coagulopathy. Autopsies revealed skin, adrenal, and central nervous system involvement, with acute myocarditis frequently missed clinically.
Area of Science:
- Pediatric Pathology
- Infectious Diseases
- Microbiology
Background:
- Meningococcal infections are a significant cause of childhood mortality.
- Understanding the pathological findings is crucial for diagnosis and management.
- Disseminated intravascular coagulopathy (DIC) is a known complication.
Purpose of the Study:
- To analyze the pathological findings in fatal pediatric meningococcal infections.
- To identify common organ involvement and complications.
- To assess the clinical diagnosis of acute myocarditis.
Main Methods:
- Retrospective autopsy study of 86 children with fatal meningococcal infection.
- Analysis of pathological changes, including disseminated intravascular coagulopathy.
- Histological examination for acute myocarditis.
Main Results:
- Overwhelming bacterial infection and DIC were prominent findings.
- Skin, adrenal glands, and CNS were most commonly affected.
- Acute myocarditis occurred in 27% of cases, predominantly diagnosed histologically.
Conclusions:
- Autopsy reveals extensive pathology in fatal meningococcal disease.
- Clinical diagnosis of acute myocarditis is often missed.
- Improved nutritional status and immune reactivity were noted in the study population.