Abstract
Sixty nine patients with meningococcal disease some of whom presented with a maculopapular rash were entered in a prospective multicentre study. The clinical and laboratory features of children presenting with maculopapular rashes were compared with those of children presenting with typical haemorrhagic rashes. Of the 69 children 26 (38%) developed maculopapular rashes; nine (13%) had a maculopapular rash only, and the remaining 17 had a mixed maculopapular-purpuric rash. Twelve of the 17 (7%) had less than 12 petechiae. Children with maculopapular rashes had significantly higher platelet counts (median 294 compared with 243 x 10(9)/l), and plasma total haemolytic complement activity (80.5 compared with 65.0 U/ml) and significantly lower Glasgow meningococcal septicaemia prognostic scores (2.5 compared with 5.5) than those with purpuric rashes on admission. There were no significant differences between the groups in mortality, white cell count or absolute neutrophil count on admission, or C reactive protein concentration. Meningococcal disease can present with a maculopapular rash alone but this does not necessarily mean that the disease is less severe.
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- Ansari B. M., Davies D. B., Boyce J. M. A comparative study of adverse factors in meningococcaemia and meningococcal meningitis. Postgrad Med J. 1979 Nov;55(649):780–783. doi: 10.1136/pgmj.55.649.780. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Baxter P., Priestley B. Meningococcal rash. Lancet. 1988 May 21;1(8595):1166–1167. doi: 10.1016/s0140-6736(88)91981-2. [DOI] [PubMed] [Google Scholar]
- Beatty D. W., Ryder C. R., Heese H. D. Complement abnormalities during an epidemic of group B meningococcal infection in children. Clin Exp Immunol. 1986 Jun;64(3):465–470. [PMC free article] [PubMed] [Google Scholar]
- Brandtzaeg P., Dahle J. S., Høiby E. A. The occurrence and features of hemorrhagic skin lesions in 115 cases of systemic meningococcal disease. NIPH Ann. 1983 Dec;6(2):183-90, 202-3. [PubMed] [Google Scholar]
- Carter P. E. Meningococcal meningitis. BMJ. 1990 Jun 16;300(6739):1584–1584. doi: 10.1136/bmj.300.6739.1584-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kahn A., Blum D. Factors for poor prognosis in fulminating meningococcemia. Conclusions from observations of 67 childhood cases. Clin Pediatr (Phila) 1978 Sep;17(9):680-2, 687. doi: 10.1177/000992287801700902. [DOI] [PubMed] [Google Scholar]
- Leclerc F., Beuscart R., Guillois B., Diependaele J. F., Krim G., Devictor D., Bompard Y., van Albada T. Prognostic factors of severe infectious purpura in children. Intensive Care Med. 1985;11(3):140–143. doi: 10.1007/BF00258539. [DOI] [PubMed] [Google Scholar]
- 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]
- Rubenstein R., Esterly N. B. Meningococcal meningitis with a benign skin rash. Pediatr Dermatol. 1986 Nov;3(5):414–416. doi: 10.1111/j.1525-1470.1986.tb00553.x. [DOI] [PubMed] [Google Scholar]
- Sinclair J. F., Skeoch C. H., Hallworth D. Prognosis of meningococcal septicaemia. Lancet. 1987 Jul 4;2(8549):38–38. doi: 10.1016/s0140-6736(87)93067-4. [DOI] [PubMed] [Google Scholar]
- 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]
- Toews W. H., Bass J. W. Skin manifestations of meningococcal infection; an immediate indicator of prognosis. Am J Dis Child. 1974 Feb;127(2):173–176. doi: 10.1001/archpedi.1974.02110210023003. [DOI] [PubMed] [Google Scholar]