Multicenter Study Of Meningococcal Disease In Children Pediatric Hospitals In Argentina

Background: Neisseria meningitidis infections are an important cause of morbidity and mortality in children of all ages. Latinoamerican studies of this infection are scarce. Methods: Retrospective reviews of medical and microbiologic records from Hospital de Niños Juan P Garrahan (HJPG) and Hospital de Niños Ricardo Gutierrez (HNRG), both in Buenos Aires, Argentina were done to identify patients with invasive N. meningitidis infections between 1998 and 2008. Demographic and clinical data were reviewed. OBJETIVES. To analyse the epidemiology, clinical features and outcome of invasive infections caused by N. meningitidis. Results: One hundred and twenty-six cases (HJPG: 77; HNRG: 49) of invasive meningococcal infection were analyzed during the study period. The median age at presentation was 33 months (range, 1 to 180). Fifity-two percent had male and 15% had underlying disease. Eleven percent had previous antibiotic treatment. The median time of symptoms previously to admission was 1.5 days. The most common signs and symptoms at admission included fever (96%) (> 39 °C: 40%; median duration: 3.5 days), rash (61%), nuchal rigidity (37%), vomiting (51%), irritability (59%) and lethargy (64%). The final diagnosis were: meningitis (86%), meningococcemia without meningitis (10%), septic arthritis (10%) and occult bacteremia (1.5%). Twenty-four children (19%) required ICU hospitalization. The median time of ICU admission was 5 days (range: 1-45). Four patients died (3.1%) (serotype C: 2 and without typification (WT): 2). Long term sequelae were seen in 15 patients (12%) (serogroup B: 6, C:6 and WT: 3): brain damage (4), amputation (3), deafness (3), blindness (2), language disturbs (1), hydrocefalia (1) and skin scars (1). The most frequent serogroup isolates were as follows: B (55); C (28); W135 (6) and Y (6). Almost all patients were treated with parenteral cephalosporin therapy alone. The median time of hospital admission was 8.5 days. Conclusion: Meningococcal infections remain an important cause of morbidity and mortality in children in Argentina. Although most patients recover without sequelae, there are a significant number who experience major morbidity and mortality as a result of this infection. Effective meningococcal vaccination recommendation could lessen considerably the burden of meningococal meningitis. Abstracts for SupplementInternational Journal of Infectious DiseasesVol. 14Preview Full-Text PDF Open Archive