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[Morphology of recent meningococcal infections in children]
Abstract:
An analysis of 108 cases of children's death which occurred in 1981-1991 from hypertoxic meningococcal infection (MI) in St. Petersburg is presented. Serogroup B meningococcus as a causative agent was found in 44% of the cases. The role in the thanatogenesis of inflammatory and immune reactions, viral-bacterial associations was shown on the basis of detailed study of 47 cases. Hemorrhagic adrenal necrosis was diagnosed in 94.7% of the cases. Two clinicomorphological variants of the disease are distinguished: 1) variant with a moderate hemorrhagic eruption without pronounced kidney lesion, 2) variant with an abundant confluent rash and pronounced kidney lesions and choroid plexus immune lesions.
Insights
Hypertoxic meningococcal infection (MI) caused child deaths in St. Petersburg. Serogroup B was a common cause, with inflammatory responses and adrenal necrosis playing key roles in fatalities.
Area of Science:
- Pediatrics
- Infectious Diseases
- Pathology
Background:
- Meningococcal infection (MI) remains a significant cause of pediatric mortality.
- Understanding the specific factors contributing to fatal outcomes in hypertoxic MI is crucial for improving clinical management.
Purpose of the Study:
- To analyze the clinicomorphological features and etiological factors of fatal hypertoxic meningococcal infections in children.
- To investigate the role of inflammatory and immune reactions, viral-bacterial associations, and specific pathological findings in child deaths due to MI.
Main Methods:
- Retrospective analysis of 108 pediatric deaths attributed to hypertoxic MI between 1981-1991 in St. Petersburg.
- Detailed pathological examination of 47 cases to identify etiological agents and pathogenetic mechanisms.
- Microbiological analysis to determine the serogroup of Neisseria meningitidis.
Main Results:
- Serogroup B meningococcus was identified as the causative agent in 44% of the analyzed cases.
- Inflammatory and immune reactions, along with viral-bacterial associations, were significant factors in the pathogenesis of fatal MI.
- Hemorrhagic adrenal necrosis was a prevalent finding, diagnosed in 94.7% of the cases.
- Two distinct clinicomorphological variants were identified: one with moderate rash and less severe kidney involvement, and another with abundant rash, significant kidney damage, and choroid plexus immune lesions.
Conclusions:
- Serogroup B meningococcus is a key pathogen in pediatric hypertoxic MI.
- Pathological findings such as adrenal necrosis and specific immune lesions contribute significantly to mortality.
- Distinct clinical and pathological presentations suggest varied disease trajectories in severe meningococcal infections.