Severe meningococcal disease studied from hospital records
Høst, J.H.; Sander, J.; Gedde-Dahl, T.W.
Tidsskrift for den Norske Laegeforening Tidsskrift for Praktisk Medicin Ny Raekke 103(4): 274-279
1983
ISSN/ISBN: 0029-2001 PMID: 6857608 Document Number: 215443
Hospital and military records of 103 cases of meniningococcal disease during the period 1967-1979 were analyzed retrospectively. The outcome of the disease (healthy/sequelae/dead) was related to case history, clinical signs, laboratory data and medical treatment. Recruits vaccinated with the dual vaccine against diphtheria and tetanus within 3 weeks before illness showed an increased incidence of sequelae among those surviving (P < 0.05). Patient treated with antibiotics before admission seemed to have a greater chance of surviving. The investigation showed that a broad spectrum of different antibiotic regimens has been applied in the treatment of meningococcal disease in Norway. Among patients presenting skin hemorrhages at the time of admission, those with additional signs of meningitis had a much lower case fatality rate than those without signs of meningitis (P < 0.001). Clinical signs and laboratory data accessible soon after admission may be used to predict the outcome of the disease and thus form a basis for evaluation of medical treatment. Several alternative prognostic scores proved better than those of Niklasson, Stiem and Damrosch in this series. Evidently, the change in bacterial characteristics and the change to a more malignant course of the meningococal disease observed at the start of the last epidemic in Norway are not merely coincidenetial but possibly causally related.