The changing presentations of meningococcal disease

Meningococcal disease (MCD) can present as meningitis, meningitis plus septicaemia or septicaemia alone. This 17-year retrospective study sought to determine if the proportion of cases presenting as septicaemia alone was increasing. Four hundred and forty-nine children with MCD were admitted between...

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Bibliographic Details
Published in:European journal of pediatrics 1995-06, Vol.154 (6), p.472-474
Main Authors: RIORDAN, F. A. I, MARZOUK, O, THOMPSON, A. P. J, SILLS, J. A, HART, C. A
Format: Article
Language:English
Subjects:
Bacteremia - complications
Bacteremia - epidemiology
Bacteremia - mortality
Bacterial diseases
Bacterial sepsis
Biological and medical sciences
Chi-Square Distribution
England - epidemiology
Human bacterial diseases
Humans
Infant
Infectious diseases
Medical sciences
Meningitis, Meningococcal - complications
Meningitis, Meningococcal - epidemiology
Meningitis, Meningococcal - mortality
Meningococcal Infections - complications
Meningococcal Infections - epidemiology
Meningococcal Infections - mortality
Retrospective Studies
Severity of Illness Index
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Summary:Meningococcal disease (MCD) can present as meningitis, meningitis plus septicaemia or septicaemia alone. This 17-year retrospective study sought to determine if the proportion of cases presenting as septicaemia alone was increasing. Four hundred and forty-nine children with MCD were admitted between 1977 and 1993, 50 children died (11%). The proportion of cases with septicaemia alone increased from 7% in 1977-1985 to 36% in 1990-1993 (P < 0.0005). Mortality was highest in children with septicaemia alone (19%). Despite the increase in septicaemia, overall mortality did not alter over the 17 years. MCD should not be thought of as "meningitis", since 33% of cases now present as septicaemia alone. Nearly one in five children with septicaemia alone die. Information and publicity about MCD should focus on septicaemia, characterised by a petechial rash, as the life-threatening presentation.
ISSN:0340-6199
1432-1076
DOI:10.1007/BF02029358