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

Abstract

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.