Skip to main content
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 1979 Jan;54(1):44–48. doi: 10.1136/adc.54.1.44

Prognostic factors in acute meningococcaemia.

L S Lewis
PMCID: PMC1545202  PMID: 420520

Abstract

During a meningococcal (group A) epidemic, 47 Nigerian children with acute meningococcaemia without meningitis were studied. Their mortality rate was 43% compared with 8% during the whole epidemic. Those presenting with coma and shock had a mortality of 93%, but without shock or coma mortality was only 6%. Coma or shock occurring alone carried an intermediate prognosis. The outcome correlated with initial serum antigen titre, but not with the serum levels of endotoxin, cortisol, or fibrin degradation products. Chloramphenicol was as effective as penicillin. A predictor of expected mortality, based on serum antigen titre and the presence of coma or shock, may allow new forms of treatment to be assessed.

Full text

PDF
47

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Cahalane S. F., Waters M. Fulminant meningococcal septicaemia. A hospital experience. Lancet. 1975 Jul 19;2(7925):120–121. doi: 10.1016/s0140-6736(75)90017-3. [DOI] [PubMed] [Google Scholar]
  2. Ducker T. B., Simmons R. L. The pathogenesis of meningitis. Systemic effect of meningococcal endotoxin within the cerebrospinal fluid. Arch Neurol. 1968 Feb;18(2):123–128. doi: 10.1001/archneur.1968.00470320025002. [DOI] [PubMed] [Google Scholar]
  3. Edwards E. A. Immunologic investigations of meningococcal disease. I. Group-specific Neisseria meningitidis antigens present in the serum of patients with fulminant meningococcemia. J Immunol. 1971 Feb;106(2):314–317. [PubMed] [Google Scholar]
  4. Goldschneider I., Gotschlich E. C., Artenstein M. S. Human immunity to the meningococcus. I. The role of humoral antibodies. J Exp Med. 1969 Jun 1;129(6):1307–1326. doi: 10.1084/jem.129.6.1307. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Greenwood B. M., Onyewotu I. I., Whittle H. C. Complement and meningococcal infection. Br Med J. 1976 Apr 3;1(6013):797–799. doi: 10.1136/bmj.1.6013.797. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Hardman J. M., Earle K. M. Myocarditis in 200 fatal meningococcal infections. Arch Pathol. 1969 Mar;87(3):318–325. [PubMed] [Google Scholar]
  7. Levin J., Poore T. E., Young N. S., Margolis S., Zauber N. P., Townes A. S., Bell W. R. Gram-negative sepsis: detection of endotoxemia with the limulus test. With studies of associated changes in blood coagulation, serum lipids, and complement. Ann Intern Med. 1972 Jan;76(1):1–7. doi: 10.7326/0003-4819-76-1-1. [DOI] [PubMed] [Google Scholar]
  8. Levin S., Painter M. B. The treatment of acute meningococcal infection in adults. A reappraisal. Ann Intern Med. 1966 May;64(5):1049–1056. doi: 10.7326/0003-4819-64-5-1049. [DOI] [PubMed] [Google Scholar]
  9. MURPHY B. P., ENGELBERG W., PATTEE C. J. Simple method for the determination of plasma corticoids. J Clin Endocrinol Metab. 1963 Mar;23:293–300. doi: 10.1210/jcem-23-3-293. [DOI] [PubMed] [Google Scholar]
  10. Manios S. G., Kanakoudi F., Maniati E. Fulminant meningococcemia. Heparin therapy and survival rate. Scand J Infect Dis. 1971;3(2):127–133. doi: 10.3109/inf.1971.3.issue-2.06. [DOI] [PubMed] [Google Scholar]
  11. Murray J. D., Fleming P., Weber J., Hsuen J., Bannatyne R., Anglin C. The continuing problem of purulent meningitis in infants and children. Pediatr Clin North Am. 1974 Nov;21(4):967–980. doi: 10.1016/s0031-3955(16)33074-7. [DOI] [PubMed] [Google Scholar]
  12. Niklasson P. M., Blombäck M., Lundbergh P., Strandell T. Thrombocytopenia and bleeding complications in severe cases of meningococcal infection treated with heparin, dextran 70 and chlorpromazine. Scand J Infect Dis. 1972;4(3):183–191. doi: 10.3109/inf.1972.4.issue-3.03. [DOI] [PubMed] [Google Scholar]
  13. Niklasson P. M., Lundbergh P., Strandell T. Prognostic Factors in meningococcal disease. Scand J Infect Dis. 1971;3(1):17–25. doi: 10.3109/inf.1971.3.issue-1.03. [DOI] [PubMed] [Google Scholar]
  14. Stiehm E. R., Damrosch D. S. Factors in the prognosis of meningococcal infection. Review of 63 cases with emphasis on recognition and management of the severely ill patient. J Pediatr. 1966 Mar;68(3):457–467. doi: 10.1016/s0022-3476(66)80250-0. [DOI] [PubMed] [Google Scholar]
  15. Stumacher R. J., Kovnat M. J., McCabe W. R. Limitations of the usefulness of the Limulus assay for endotoxin. N Engl J Med. 1973 Jun 14;288(24):1261–1264. doi: 10.1056/NEJM197306142882402. [DOI] [PubMed] [Google Scholar]
  16. UDHOJI V. N., WEIL M. H., SAMBHI M. P., ROSOFF L. Hemodynamic studies on clinical shock associated with infection. Am J Med. 1963 Apr;34:461–469. doi: 10.1016/0002-9343(63)90068-8. [DOI] [PubMed] [Google Scholar]
  17. Whittle H. C., Oduloju A., Evans-Jones G., Greenwood B. M. Evidence for familial immune defect in meningococcal meningitis. Br Med J. 1976 May 22;1(6020):1247–1250. doi: 10.1136/bmj.1.6020.1247. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES