Терапевтический архив (Dec 2022)

Analysis of fatal outcomes of meningococcal infection in adults

  • Konstantin V. Zhdanov,
  • Aleksandr N. Kovalenko,
  • Vadim S. Chirsky,
  • Denis A. Gusev,
  • Natalia A. Nalivkina,
  • Vsevolod A. Zinserling,
  • Stepan G. Grigoriev,
  • Regina A. Khairutdinova,
  • Artem N. Isakov,
  • Valerian V. Sharabkhanov

DOI
https://doi.org/10.26442/00403660.2022.11.201931
Journal volume & issue
Vol. 94, no. 11
pp. 1252 – 1256

Abstract

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Clinical characteristics and pathomorphological manifestations in 69 patients aged 18 to 86 years with a fatal outcome of the disease were examined in order to analyze the causes of severe course and high mortality of generalized forms meningococcal infection. It was found that the main clinical form was meningococcemia (90%), in the majority in combination with meningitis (52%). The fulminant course in 77% of patients with meningococcal sepsis manifested itself as a sudden onset, rapid development of typical symptoms. Hemorrhagic exanthema was detected on the first day of meningococcemia. The leading complications and critical conditions were infectious-toxic shock, disseminated intravascular coagulation and acute adrenal insufficiency (WaterhouseFriederiksen syndrome). The severe course of meningitis (in 10%) led to the development of cerebral coma, the morphological substrate of which was edema swelling of the brain.

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