Journal Article

Meningococcal Septic Shock in Children: Clinical and Laboratory Features, Outcome, and Development of a Prognostic Score

René F. Kornelisse, Jan A. Hazelzet, Wim C. J. Hop, Lodewijk Spanjaard, Marja H. Suur, Edwin van der Voort and Ronald de Groot

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 25, issue 3, pages 640-646
Published in print September 1997 | ISSN: 1058-4838
Published online September 1997 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/513759
Meningococcal Septic Shock in Children: Clinical and Laboratory Features, Outcome, and Development of a Prognostic Score

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The clinical characteristics of and outcome for 75 children with meningococcal septic shock were studied. In addition, a new prognostic scoring system was developed. The median age of the patients was 3.2 years (range, 3 weeks to 17.9 years). The most common phenotype of Neisseria meningitidis was B:4:P1.4 (27%). A mortality rate of 21% was observed. Ten (17%) of the 59 survivors had serious sequelae. Calcium levels were significantly lower in patients with seizures. Disseminated intravascular coagulation occurred in 58% of the patients who were tested. Logistic regression analysis identified four laboratory features independently associated with mortality: serum C-reactive protein level, base excess, serum potassium level, and platelet count. These features were used to develop a novel scoring system with a predictive value for death and survival of 71% and 90%, respectively. The outcome was predicted correctly for 86% of the patients, which is higher than rates previously reported for scoring systems.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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