Meningococcemia in children: Factors influencing outcome

Abstract

Systemic meningococcal infection requires prompt and adequate medical care. It is considered as an unpredictable disease due to extreme severity of patients' condition and high risk of fatal outcome. The study was aimed to investigation of factors influencing outcomes in children with meningococcemia. Cox regression analysis was applied to estimate effects of age, septic shock, neutropenia, and use of glucocorticoids at the pre-admission stage on the risk of a fatal outcome. The retrospective cohort included all cases of meningococcemia in children that arose in the Arkhangelsk region in 1991-2013. Altogether, 90 children (35 girls and 55 boys) with meningococcemia were included in the study. All death cases occurred during the first three days of illness. The average age was 1 year 2 months. The age younger than 1 year was not associated with fatal outcomes, HR 1.0, 95 % CI 0.5-2.1. The factors influencing outcomes were septic shock, HR 11.9, 95 % CI 1.6-89.2, and neutropenia, HR 1.6, 95 % CI 1.2-2.1. Rapid diagnosis and management of septic shock is critical for successful treatment. Use of intramuscular or intravenous injections of glucocorticoids at the pre-admission stage according to the common recommendations did not improve the outcomes, HR 1.2, 95 % CI 0.6-2.4.