Table 4.
Comparison of meningococcal septicemia and ethylmalonic encephalopathy
| Meningococcal septicemia | Ethylmalonic encephalopathy | |
|---|---|---|
| Shock | + | +/− |
| Petechiae | + | + |
| Purpura | + | + |
| Peripheral perfusion | Poor | Poor |
| Positional acrocyanosis | - | + |
| Lactate/metabolic acidosis | High, normalizes | High, persistent |
| DIC | +/− | − |
| Altered conscious state | + | + |
| Seizures | +/− | +/− |
| Altered respiratory status | + | + |
| Diarrhea | +/− | +/− |
| Inflammatory markers | High | Normal/low |
| White cell count | High | Normal |
| Response to antimicrobials | Rapid | No |
| Abnormal CSF cell count/biochemistry | Yes | No |
| Meningococcal PCR or culture positive in blood or CSF | +/− | No |
| MRI brain changes | Acute | Acute on chronic/chronic |
| Abnormal neurodevelopmental history | Unlikely | Likely |
| Abnormal neurological signs | Follows rash | Precedes rash |
| Abnormal urine metabolic screen | Unlikely | Likely |
(DIC) Disseminated intravascular coagulation, (CSF) cerebrospinal fluid, (PCR) polymerase chain reaction, (MRI) magnetic resonance imaging, (+) feature is present in most cases, (−) feature is not present in most cases, (+/−) feature may or may not be present.