Clinical features of meningococcal infection in children during the epidemic upsurge in 2018

2020 ◽  
Vol 1-2 (211-212) ◽  
pp. 55-60
Author(s):  
Madina Kaldybayeva ◽  
◽  
Raushan Idrissova ◽  
Zinaidy Urikbaeva ◽  
Sergey Khokhulya ◽  
...  
Keyword(s):  
Septic Shock ◽  
Clinical Features ◽  
High Mortality ◽  
Blood Parameters ◽  
Meningococcal Meningitis ◽  
Meningococcal Infection ◽  
Laboratory Examination ◽  
Mixed Form ◽  
Retrospective Assessment ◽  
Red Flag

In the Repiblic of Kazakhstan in 2018, there was an increase in generalized meningococcal infection (GFMI), which potentially has a risk of high mortality. The aim of the study was to study the clinical features of generalized meningococcal infection (meningococcal meningitis, meningococcal meningitis and mixed-form meningococcal meningitis) during the epidemic upsurge, as well as to evaluate early symptoms of the disease according to new international criteria, 2018. Material and methods. The article describes 59 children aged from 5 months. up to 16 years old. Of these, 35 children (26 boys) with generalized meningococcal infection (GMI): 1 group, age from 0.5 to 10 years with meningitis and meningococcemia (combined GMI) and 2 group, age from 2 to 16 years with meningococcemia - 24 (15 boys). All children underwent a complete clinical and laboratory examination. All children with a retrospective assessment of "red flag" symptoms was performed according to the latest recommendations supported by who the Severity of combined GMI and isolated meningococcemia is almost identical in mortality (8.6% for combined meningitis and meningococcemia and 8.4% for isolated meningococcemia). Results and discussion. In combined GMI, the severity is determined by pleocytosis in the CSF and correlates with inflammatory blood parameters; in isolated meningococcemia, the severity is due to symptoms of shock, primarily cardiovascular insufficiency. Conclusions. Red flag symptoms are particularly significant in children over 3 years of age and adolescents and are specific predictors of septic shock, especially in isolated meningococcemia (83%), but to a slightly lesser extent in combined GMI (71%). Keywords: generalized meningococcal infection, children, epidemic upsurge, meningococcemia, meningitis.

CLINICAL FEATURES AND COAGULATION ABNORMALITIES IN CHILDREN WITH SEPSIS AT DANANG HOSPITAL FOR WOMEN AND CHILDREN

2018 ◽  
pp. 97-103
Author(s):  
Huu Hoi Vo ◽  
Binh Bao Son Bui
Keyword(s):  
Septic Shock ◽  
Clinical Features ◽  
Cross Sectional Study ◽  
Severe Thrombocytopenia ◽  
Cross Sectional ◽  
Hematologic Tests ◽  
Coagulation Abnormalities ◽  
Women And Children ◽  
Key Words Coagulation ◽  
Coagulation Dysfunction

Objective: To determine the relationship between coagulation abnormalities and main clinical features, and hematologic tests. Methods: A descriptive cross-sectional study was conducted in 65 children with sepsis at the PICU, Da Nang Hospital for Women and Children from April 2012 to June 2013. Results: The frequency of internal hemorrhage in septic shock children was significantly higher than in children with sepsis (p < 0.001). The rate of thrombocytopenia was 30.8%, in which 10.8% of the children had severe thrombocytopenia (<50 x 109/l). Hypofibrinogenemia was observed in 30.8% of the patients, in which severe hypofibrinogenemia (≤ 1 g/l) was observed in 16.9% of the children. The frequency of reduced prothrombin ratio was 40%, in which 23.1% of the patients had prothrombin ratio < 50%. 35.4% of the patients had rAPTT > 1.15. Positive D-dimer and DIC were observed in 53.8% and 20% of the patients, respectively. Hemostatic changes showed the significant relationship with hemorrhage and the mortality of sepsis. Conclusion: Children with sepsis, especially septic shock were at high risk of coagulation dysfunction and coagulation abnormalities showed the correlation with hemorrhage and the mortality of sepsis. Key words: coagulation abnormalities, sepsis, children

scholarly journals Improving the therapy of generalized forms of Meningococcal infection in children using extracorporeal hemocorrection

2021 ◽  
Vol 20 (2) ◽  
pp. 49-56
Author(s):  
K. V. Markova ◽  
E. Yu. Skripchenko ◽  
K. V. Serednyakov ◽  
Yu. V. Lobzin ◽  
N. V. Skripchenko ◽  
...  
Keyword(s):  
Septic Shock ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Multiple Organ ◽  
Meningococcal Infection ◽  
Basic Drug ◽  
Inflammatory Reactions ◽  
Clinical Center ◽  
Refractory Septic Shock ◽  
Group 2

Invasive meningococcal infection is a significant cause of death, reaching 80% in septic shock. The Pediatric Research and Clinical Center for Infectious Diseases (PRCCID) has developed an algorithm for the treatment of children with invasive meningococcal infection with refractory septic shock and multiple organ failure syndrome, which includes basic drug therapy with polymyxin hemoperfusion in combination with extended methods of extracorporeal hemocorrection.Purpose: to evaluate the effectiveness of extracorporeal hemocorrection operations in children with invasive meningococcal infection with refractory septic shock and multiple organ failure syndrome.Materials and research methods: to the intensive care unit of the PRCCID for the analyzed period 2006—2020 34 children were hospitalized with invasive meningococcal infection with refractory septic shock and multiple organ failure syndrome. Two groups were formed: Group 1 — children admitted to the PRCCID in the period 2014—2020 (n = 23), who underwent polymyxin hemoperfusion simultaneously with extended methods of extracorporeal hemocorrection, group 2 — children hospitalized in 2006—201 3 (n = 1 1), methods of extracorporeal hemocorrection were not performed. The Mann-Whitney U-test and ANOVA were used to evaluate the results.Results and discussion: the use of extracorporeal hemocorrection operations in the complex therapy of invasive forms of meningococcal infection with refractory septic shock and multiple organ failure syndrome in children provides stabilization of central hemodynamics, reduces clinical and laboratory inflammatory reactions, helps to reduce the dose of vasopressor drugs and parameters of respiratory support, and also increases patient survival rate by 82.6%.

Meningococcal Meningitis in Familial Deficiency of the Fifth Component of Complement

PEDIATRICS ◽  
1981 ◽  
Vol 67 (6) ◽  
pp. 882-886
Author(s):  
Georges Peter ◽  
Mary Beth Weigert ◽  
Arthur A. Bissel ◽  
Ronald Gold ◽  
Donald Kreutzer ◽  
...  
Keyword(s):  
Age Of Onset ◽  
Early Adulthood ◽  
Meningococcal Meningitis ◽  
Host Susceptibility ◽  
Meningococcal Infection ◽  
First Year ◽  
Hemolytic Assay ◽  
The Family ◽  
Hemolytic Complement Activity ◽  
First Year Of Life

Absence of the fifth component of complement (C5) by immunochemical assay and marked deficiency by hemolytic assay (&lt;0.1%) was found in a family in which the oldest male child had suffered severe and recurrent meningococcemia at age 15 years, two brothers developed meningococcal meningitis four years later (at ages 18 and 14 years), and a sister had the gonococcal arthritis-dermatitis syndrome. Although group-specific meningococcal antibody was present in the sera from all four siblings, serum bactericidal activity against Neisseria meningitidis could be demonstrated only in the presence of exogeous rabbit complement. Serum total hemolytic complement activity was undetectable in all four, but was restored to normal by the addition of purified C5. Subsequently, a second episode of group Y meningococcal meningitis was experienced by one brother and presumed gonococcal arthritis-dermatitis syndrome recurred in the sister. The family is the largest C5-deficient kindred to be reported and emphasizes the importance of C5 in host susceptibility to invasive Neisseria infections. In contrast to the peak incidence of N meningitidis disease in the general population in the first year of life, age of onset of meningococcal infection in these patients and in the 13 previously reported patients with terminal complement component deficiency has usually been in adolescence and early adulthood.

scholarly journals Clinical Features, Outcomes, and Risk Factors of Bloodstream Infections due to Stenotrophomonas maltophilia in a Tertiary-Care Hospital of China: A Retrospective Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Yibing Chen ◽  
Jijiang Suo ◽  
Mingmei Du ◽  
Liangan Chen ◽  
Yunxi Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Septic Shock ◽  
Drug Resistance ◽  
Clinical Features ◽  
Stenotrophomonas Maltophilia ◽  
Pathogenic Bacteria ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
T Tube

Background. Stenotrophomonas maltophilia bacteremia (SMB) is the most perilous situation as compared to other types of S. maltophilia infection. The present study aimed to investigate the clinical features, distribution, drug resistance, and predictors of survival of SMB in a tertiary-care hospital of China. Methods. SMB that occurred in a tertiary-care hospital in Beijing, China, within 9 years (2010–2018) was investigated in a retrospective study. Demographics, incidence, commodities, drug resistance, mortality, as well as antibiotics administration were summarized according to the electronic medical records. The risk factors for survival were analyzed by Chi-square test, Kaplan–Meier curve and Cox regression. Results. A total of 76 episodes of SMB were analyzed. The overall incidence of SMB fluctuated from 3.4 to 15.4 episodes per 1000 admissions over 9 years. Malignancy was the most common comorbidity. High in vitro sensitivity was observed to minocycline (96.1%), levofloxacin (81.6%), and trimethoprim-sulfamethoxazole (89.5%). Central venous catheter (CVC) (p=0.004), mechanical ventilation (MV) (p=0.006), hemodialysis (p=0.024), and septic shock (p=0.016) were significantly different between survival and death group. The 30-day mortality was 34.2% within 30 days after confirmation of blood culture. Factors such as hemodialysis (OR 0.287, 95% CI: 0.084–0.977, p=0.046), T-tube (OR 0.160, 95% CI: 0.029–0.881, p=0.035), and septic shock (OR 0.234, 95% CI: 0.076–0.719, p=0.011) were associated with survival. Conclusions. S. maltophilia is the major nosocomial blood stream infectious pathogenic bacteria. Trimethoprim-sulfamethoxazole and minocycline are optimal antibiotics for the treatment of SMB. T-tube, hemodialysis, and septic shock were the risk factors associated with survival of SMB patients.

scholarly journals Two cases of septic shock with different outcomes caused by non-O1/non-O139 Vibrio cholerae isolates

2020 ◽  
Vol 48 (6) ◽  
pp. 030006052093345
Author(s):  
Jie Chen ◽  
Jian Huang ◽  
Meirong Huang ◽  
Zehui Chen ◽  
Anlin Chen ◽  
...  
Keyword(s):  
Septic Shock ◽  
Vibrio Cholerae ◽  
High Mortality ◽  
Virulence Genes ◽  
Antibiotic Sensitivity ◽  
Sporadic Cases ◽  
Human Infections ◽  
Sequence Types

In recent decades, increasing numbers of human infections have been linked to non-O1/non-O139 Vibrio cholerae. Septicemia resulting from non-O1/non-O139 V. cholerae infection is rare but has high mortality. The pathogenesis of non-O1/non-O139 V. cholerae septicemia is poorly understood. Here, we report two sporadic cases of septicemia following non-O1/non-O139 V. cholerae infection from an inland area of China. Patient 1 died rapidly within 24 hours, while patient 2 gradually recovered from septic shock. To explore the reasons for these divergent outcomes, we compared the two cases, tested the antibiotic sensitivity of the two isolates, and investigated their virulence genes and sequence types.

scholarly journals Acute Febrile Encephalopathy in Children: A Prospective Study of Clinical Features, Etiology, Mortality, and Risk Factors from Western India

2018 ◽  
Vol 09 (01) ◽  
pp. 019-025 ◽  
Author(s):  
Kirti Gupta ◽  
Charul S. Purani ◽  
Anirban Mandal ◽  
Amitabh Singh
Keyword(s):  
Risk Factors ◽  
Respiratory Failure ◽  
Clinical Features ◽  
High Mortality ◽  
Tertiary Care ◽  
Primary Objective ◽  
Medical Emergency ◽  
Western India ◽  
Care Hospital ◽  
Factors Associated

ABSTRACT Introduction: Acute febrile encephalopathy (AFE) in children is a medical emergency and could be a manifestation of many systemic and central nervous system pathologies. The clinical features of AFE are nonspecific and etiological spectrum variable depending on the studied population. Materials and Methods: A prospective, observational study was carried out including children aged between 1 month and 12 years with AFE admitted to the Pediatric Intensive Care Unit of a tertiary care hospital in Western India. The primary objective was to assess the clinical presentation and etiology of AFE while the secondary objectives were to correlate the clinical and etiological findings and to determine the risk factors associated with mortality. Results: Out of the ninety children with AFE included in this study, male:female ratio was 1.2:1; most of them were aged between 1 and 5 years and came with a history of <7 days (82.2%). All of them had altered sensorium, about 2/3rd had seizures and 47.8% having a Glasgow Coma Score (GCS) <8. Etiology remained elusive in about 40% of the cases, and viral infections were the most common among the ones with an identifiable cause. A variety of morbidity (shock, disseminated intravascular coagulopathy, respiratory failure, etc.) and high mortality (40%) was observed with risk factors associated with mortality being GCS <8, the presence of raised intracranial pressure, shock, and respiratory failure. Conclusion: AFE, though a rare diagnosis in children, is associated with significant morbidity and high mortality in a developing country like India.

HIGH MORTALITY WITH STAPHYLOCOCCAL SEPTIC SHOCK IN ADOLESCENTS DESPITE USE OF EXTRACORPO-REAL THERAPIES.

2006 ◽  
Vol 34 ◽  
pp. A111 ◽  
Author(s):  
Matthew L Paden ◽  
Scott F Wagoner ◽  
James D Fortenberry
Keyword(s):  
Septic Shock ◽  
High Mortality

Myocardial depression in septic shock caused by meningococcal infection

1984 ◽  
Vol 12 (12) ◽  
pp. 1021-1023 ◽  
Author(s):  
F. MONSALVE ◽  
L. RUCABADO ◽  
A. SALVADOR ◽  
J. BONASTRE ◽  
J. CUNAT ◽  
...  
Keyword(s):  
Septic Shock ◽  
Meningococcal Infection ◽  
Myocardial Depression

scholarly journals Profil Klinis dan Luaran Syok Sepsis pada Pasien Anak yang Dirawat di PICU RSUP Dr. M. Djamil Padang

2021 ◽  
Vol 1 (3) ◽  
pp. 234-238
Author(s):  
Yoga Gandha Prasetya ◽  
Indra Ihsan ◽  
Amirah Zatil Izzah
Keyword(s):  
Septic Shock ◽  
Mortality Rate ◽  
General Hospital ◽  
High Mortality ◽  
Pediatric Patients ◽  
Clinical Manifestations ◽  
Sampling Technique ◽  
Target Population ◽  
Pediatric Emergency ◽  
One Year

Background. Septic shock is a common pediatric emergency with a high mortality rate. Objective. The purpose of this study was to determine the clinical profile and outcome of septic shock in pediatric patients treated at PICU of DR. M. Djamil Padang State General Hospital. Method. This descriptive study used data from medical records, conducted in the Medical Record Department of DR. M. Djamil Padang State General Hospital. The target population was pediatric patients which was diagnosed with septic shock in PICU through 2015 - 2017. Samples were collected by the total sampling technique. Result. During the following study of ninety-one patients septic and forty-eight having septic shock. Children having septic shock were commonly under one year of age, female, low nutritional status, having central neuron system infection of Klebsiella sp, having less than two organ dysfunctions with clinical manifestations of Hyperthermia, Tachycardia, and Tachypnea. Hematological profile found that patients commonly had anemia, leukocytosis, thrombocytopenia, and normal I/T ratio. Shock septic outcomes were found high mortality rate, almost some patients use a ventilator, high inotropic usage, and length of stay in living patients compared to dead. Conclusion. The study concluded that prevalence Septic Shock pediatric still high with higher mortality and also morbidity

scholarly journals Extracorporeal hemocorrection in treatment of meningococcal septic shock in children

2019 ◽  
Vol 9 (2) ◽  
pp. 35-40
Author(s):  
Konstantin V. Serednyakov ◽  
Yuri V. Lobzin
Keyword(s):  
Septic Shock ◽  
Infectious Diseases ◽  
Clinical Research ◽  
Organ System ◽  
Meningococcal Infection ◽  
System Failure ◽  
Clinical Research Center ◽  
Organ System Failure ◽  
Meningococcal Septic Shock ◽  
Refractory Septic Shock

Purpose: to estimate the effectiveness of extracorporeal hemocorrection in treatment of refractory meningococcal septic shock in children.Methods: patients with generalized form of meningococcal infection, multi-organ system failure and refractory septic shock admitted to the resuscitation department of Children’s Clinical Research Center for Infectious Diseases of the Federal Medical and Biological Agency of Russia underwent extracorporeal hemocorrection (polymyxin adsorption, continuous veno-venous hemofiltration, continuous veno-venous hemodiafiltration). MultiFiltrate apparatus was used (Fresenius Medical Care, Germany).Results: application of extracorporeal hemocorrection technique in the therapy of refractory meningococcal septic shock reduced the mortality from 44.4% to 25%.Conclusion: effectiveness of extracorporeal hemocorrection when treating patients with refractory meningococcal septic shock is established. A small number of examined patients is a limitation of the study.

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