Çocuk Sağlığı ve Hastalıkları Dergisi 2008 , Vol 51 , Num 1
The factors affecting mortality in meningococcal disease
Başak Akyıldız1, Nedret Uzel2, Agop Çitak3, Demet Soysal4, Metin Karaböcüoğlu2, Raif Üçsel3
1Erciyes Üniversitesi Tıp Fakültesi Pediatri Uzmanı
2İstanbul Üniversitesi İstanbul Tıp Fakültesi Pediatri Profesörü
3İstanbul Üniversitesi İstanbul Tıp Fakültesi Pediatri Doçenti
4İstanbul Üniversitesi İstanbul Tıp Fakültesi Pediatri Uzmanı
Akyıldız B, Uzel N, Çitak A, Soysal D, Karaböcüoğlu M, Üçsel R. (Department of Pediatrics, İstanbul University İstanbul Medical Faculty, İstanbul, Turkey). The factors affecting mortality in meningococcal disease. Çocuk Sağlığı ve Hastalıkları Dergisi 2008; 51: 26-30.

Meningococcemia is a disease characterized by petechiae, purpuric rash and fever, and may cause multiple orgain failure and septic shock. In this study, we aimed to evaluate the course of the disease, and the effect of developing complications on mortality in childhood. Between January 2000 and December 2005, 65 patients were enrolled retrospectively to the study. Demograpich data, symptoms, Glasgow coma score, PRISM score, the necessity of mechanical ventilation and the length of ventilation, medical treatment, hematological and biochemical parameters, length of hospital stay, organ involvement, and complications were evaluated. Thirty-three patients were male (50.7%) and 32 (49.3%) were female, with mean age of 45±32.2 months and 41.5±29.4 months, respectively. Meningococcemia and meningitidis were coexistentin 15 patients (15%), meningitidis alone in 20 patients (30.7%) and meningococcemia alone in 30 patients (46.1%). In this study, 12 cases died (10 meningococcemia, 2 meningococcemia+meningitidis). The mortality rate was found high in girls and in those younger than two years (p<0.05). In nonsurvivors, Glasgow coma score was found low and PRISM score high (p<0.05). The existence of prolonged PT and PTT, neutropenia and thrombocytopenia was found to be significant in increasing the ratio of mortality (p<0.05, p<0.01, p<0.05). Plasma sodium and calcium levels were significantly lower in nonsurvivors (p<0.05). Mortality was significantly higher in patients with involment of more than four organs (p<0.0001). The cardiovascular system was mostly involved. In 11 patients, complications due to meningococcemia were detected (4 arthritis, 3 myocarditis, 2 acute respiratory distress syndrome and 2 acute renal failure). In meningococcemia, it is essential to prevent complications by early diagnosis and aggressive therapy. Anahtar Kelimeler : meningokoksemi, peteşi, çoklu organ yetersizliği, meningococcemia, petechiae, multiorgan failure

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