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[Treatment of meningococcal sepsis]
Background:
Incidence of meningococcal diseases and sepsis caused by a new invasive strain of Neisseria meningitidis group C: 2a: P 1,2 has been observed in the Czech republic within the last 3 years. In 1994 the highest incidence of this disease was in the West region. Ten of the most critically ill patients were treated at the Department of Anaesthesiology and Intensive Care. The aim of this work was to present principles of the treatment of this disease.
Methods And Results:
In 1994 we treated 10 patients, 8 male and 2 female with average age of 11 years (range from 5 months to 20 years). Causing strain identification was done in 9 patients, in one patient causing strain was not identified. All patients had typical clinical symptoms of the disease. All of them were treated according to the same protocol of the invasive complex treatment including artificial ventilation, circulation support, Ceftriaxon combined with potassium salt of benzylpenicillin, i.v. immunoglobulins, fresh frozen plasma, heparin, fibrinogen and antitrombin III. Average length of the stay in the Intensive Care Unit was 5 days (range from 1.5 hour to 10 days). Survival in our group was 70%.
Conclusions:
Early started complex therapy is a decisive factor of its success. A uniform protocol of treatment and its wide publication even to the first contact level can increase a chance for survival.
Insights
Early, complex treatment of invasive meningococcal disease caused by a new Neisseria meningitidis group C strain significantly improves survival rates. A standardized treatment protocol is crucial for managing this severe sepsis.
Area of Science:
- Medicine
- Infectious Diseases
- Intensive Care Medicine
Background:
- Increased incidence of invasive meningococcal disease and sepsis caused by Neisseria meningitidis group C (2a: P 1,2) observed in the Czech Republic.
- The West region reported the highest incidence in 1994.
- Ten critically ill patients were treated at the Department of Anaesthesiology and Intensive Care.
Purpose of the Study:
- To present the principles of treating invasive meningococcal disease caused by a new Neisseria meningitidis group C strain.
- To highlight the importance of early and complex therapeutic interventions.
Main Methods:
- Treatment of 10 patients (8 male, 2 female; average age 11 years) with invasive meningococcal disease.
- Strain identification performed in 9 patients.
- Standardized complex treatment protocol including artificial ventilation, circulation support, antibiotics (Ceftriaxone and benzylpenicillin), immunoglobulins, fresh frozen plasma, heparin, fibrinogen, and antithrombin III.
Main Results:
- All patients presented with typical clinical symptoms.
- Average intensive care unit stay was 5 days.
- Overall survival rate in the treated group was 70%.
Conclusions:
- Early initiation of complex therapy is critical for successful outcomes in invasive meningococcal disease.
- A uniform treatment protocol, widely disseminated, can enhance patient survival chances.