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 Vol. 15 No. 5, May 2006
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AAP Grand Rounds 15:56-57 (2006)
© 2006 American Academy of Pediatrics

INFECTIOUS DISEASES/SENIOR MEMBERS

Diagnosing Meningococcal Disease

Source: Thompson MJ, Ninis N, Perera R, et al. Clinical recognition of meningococcal disease in children and adolescents. Lancet. 2006;367:397–403.[Medline]

The first 20% of the full text of this article appears below.

Meningococcal disease occurs worldwide; in developed countries during endemic periods, the mortality can be as great as 10%.1–5 A practitioner’s experience with meningococcal disease is often quite limited. The potential for extremely rapid progression to a severe or fatal outcome requires that physicians recognize the signs and symptoms of meningococcal disease as early in the clinical course as possible. Most pediatricians rely on textbook descriptions of classic features that usually occur relatively late in the course of meningococcal disease – purpura, meningismus, and shock – to signal the need to consider meningococcal disease when evaluating a child who is ill. This study from the University of Oxford, United Kingdom, is a retrospective review designed to assess the sequence, development, and timing of the early signs of meningococcal disease to aid clinicians in making the earliest possible diagnosis. Patients, aged 0–16 years, hospitalized from December 1997 to February 1999 in England, Wales, and . . . [Full Text of this Article]

Donald Schiff, MD, FAAP
University of Colorado School of Medicine and The Children’s Hospital, Denver, CO