Clinical and Laboratory Manifestations of Meningococcemia in Children

Lack of vaccination and modern health care facilities in many countries including iran let meningococcemia to remain as aserious challenging disorder especially among children and in spite of improved diagnosis and earlier treatment its prognosisis still dismal. this study describes 68 cases (54.4% male) of proved meningococcemia hospitalized since 1992 up to theend of 2002 in children medical center hospital, tehran, iran. infants of 6 to 12 month old were a major concern in number(14.7%) and severity of disease. 5.9% of the cases have had at least two hospitalization history for meningococcal septicemia and 19.1% of the patients had systemic lupus erythematosus (sle), nephrotic syndrome or chronic liver disease intheir past medical history. meningeal irritation signs were seen in 55.9% and cerebro spinal fluid (csf) smear was positivein 71.4% and culture was positive in 48.5% of patients. meningococcal septicemia ended in shock (38.2%), disseminated intravascular coagulation (dic) (7.4%), thrombocytopenia (10.3%), arthritis (4.4%),ocular complications (2.9%), pericarditis(2.9%) and seizure (8.8%) in 51 of the cases, and death occurred in 7 patients. this study shows that the manifestation ofthe disease is similar to those described elsewhere except for lower pneumonia and no seasonal variations.