The risk factors affecting prognosis in meningococcal diseases in children

To evaluate the risk factors affecting the prognosis of meningococcal diseases, the clinical and laboratory findings of 59 patients treated for meningococcal disease between 1989 and 1993 in the Faculty of Medicine of University of Cukurova, Division of Pediatric Infectious Diseases were analyzed retrospectively. The overall case fatality rate was 18.6% being lowest among patients over five years old (8.7%, 2/23), indicating that lower the age higher the fatality rates. There was a significant chi-square for trend for decreasing case fatality rate with increasing age (p < 0.01). Presence of hypotension, peripheral white blood cell being less than 5000/mm3, altered mental status, thrombocytopenia (< 100000/mm3), onset of petechiae within 12 hours prior to hospitalization, prolonged prothrombin time and partial thromboplastin time, and elevated serum creatinine values were found to be the prognostic factors affecting the mortality in meningococcal diseases. Absence of meningitis, type of petechiae and high fever didn't show any significant effect on mortality. We propose a new and practical scoring system with additional prognostic factors. The knowledge of the prognostic factors may minimalize the mortality in meningococcal diseases