Clinical and laboratory manifestations of meningococcemia in children

ABSTRACT

Lack of vaccination and modern health care facilities in many countries including Iran let meningococcemia to remain as a serious challenging disorder especially among children and in spite of improved diagnosis and earlier treatment its prognosis is still dismal. This study describes 68 cases [54.4% male] of proved meningococcemia hospitalized since 1992 up to the end of 2002 in Children Medical Center Hospital, Tehran, Iran. Infants of 6 to 12 month old were a major concern in number [14.7%] and severity of disease. 5.9% of the cases have had at least two hospitalization history for meningococcal septicemia and 19.1% of the patients had Systemic Lupus Erythematosus [SLE], nephrotic syndrome or chronic liver disease in their past medical history. Meningeal irritation signs were seen in 55.9% and cerebrospinal fluid [CSF] smear was positive in 71.4% and culture was positive in 48.5% of patients. Meningococcal septicemia ended in shock [38.2%], Disseminated intravascular coagulation [DIC] [7.4%], thrombocytopenia [10.3%], arthritis [4.4%],ocular complications [2.9%], pericarditis [2.9%] and seizure [8.8%] in 51 of the cases, and death occurred in 7 patients. This study shows that the manifestation of the disease is similar to those described elsewhere except for lower pneumonia and no seasonal variations