Meningococcemia in Pediatric Intensive Care Units: demographic, epidemiological, and clinical characteristics

OBJECTIVE:

The aim of this study was to review demographic, epidemiological, clinical, and laboratory characteristics of meningococcemia patients in pediatric intensive care units (PICUs).

METHODS:

Investigators from 4 different PICUs reviewed the medical records of children aged between 1 month to 18 years old who were diagnosed with meningococcemia with or without meningitis.

RESULTS:

There were a total of 33 patients in the study period. The median age at the admission was 3,4±2.1 years. 22 (67%) of the patients were male. Fever was the first symptom in 84% and meningococcemic rashes were peresent at the admission in 97% of the patients. Lumbar puncture was performed in 45% of the patients and 7 (21%) of them had meningitis with meningococcemia. N. meningitidis was cultured from 7 blood and 2 cerebrospinal fluid samples. An average of 60 mL/kg fluid bolus was given to 93% of the patients within the first hour of hospital admission. Dopamine, dobutamine, and epinephrine were given to patients who required inotropic and vasopressor infusions (54.5%, 27.2%, 12.1% of the patients, respectively). Fifty-eight percent of the patients received steroid therapy and 12% of them received heparin infusion for disseminated intravascular coagulation and purpura fulminans. The mean length of PICU stay was 6 days (1 to 29 days) and the overall mortality rate was 21% (7 patients).

CONCLUSION:

Although demographic, epidemiological, clinical, and laboratory characteristics of our patients were similar to previous reports, mortality rate was higher.