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[Acute meningococcal disease. Its prognostic assessment]

J A Bermúdez de la Vega1, A Gómez Calzado, M Sobrino Toro

  • 1Cátedra de Pediatría y Puericultura de la Facultad de Medicina, Hospital Universitario Virgen Macarena, Sevilla.

Anales Espanoles De Pediatria
|September 1, 1993
PubMed

Insights

Early treatment for acute meningococcal disease (AMD) in children significantly improves survival rates. Key indicators like leukopenia and disseminated purpura help identify severe conditions like shock and DIC early on.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Critical Care Medicine

Context:

  • Acute meningococcal disease (AMD) is a severe infection in children.
  • Assessing disease severity and prognosis is crucial for timely intervention.
  • Early identification of shock and disseminated intravascular coagulation (DIC) impacts patient outcomes.

Purpose:

  • To evaluate the discriminatory capacity of clinical variables and scoring systems in predicting shock and DIC in children with AMD.
  • To determine the optimal time intervals for assessing these severity indicators within the first 48 hours of hospitalization.
  • To correlate early treatment responses with patient survival rates.

Summary:

  • A study of 50 children with AMD analyzed the predictive value of variables like leukopenia and disseminated purpura for shock and DIC.
  • The study utilized Bjorvatn, Leclerc, and PRISM scores to assess disease severity over 8 intervals within 48 hours.
  • Leukopenia was the best predictor for shock, while disseminated purpura best predicted DIC.
  • Diagnostic capacity for shock and DIC was highest in the 0-6 and 0-12 hour periods, respectively.
  • A high survival rate of 98% was observed, linked to early shock treatment and survival beyond 12 hours.

Impact:

  • Identified key early warning signs (leukopenia, disseminated purpura) for life-threatening complications in pediatric AMD.
  • Established optimal timeframes for utilizing prognostic scores and clinical variables for timely diagnosis.
  • Demonstrated the critical importance of early intervention, particularly for shock, leading to significantly improved survival outcomes in children with AMD.

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