Akademik Veri Yönetim Sistemi
JOURNAL OF PEDIATRIC INFECTION, cilt.17, sa.4, ss.223-233, 2023 (ESCI)
Objective: Invasive meningococcal infection caused by Neisseria meningitidis leads to meningitis and sepsis with high mortality and morbidity and is a serious public health problem all over the world. In our country, it is one of the most common causes of community-acquired meningitis in children. Rapid diagnosis and therapy are life-saving. In our study, it was aimed to evaluate the clinical features, risk factors, laboratory findings and prognosis of pediatric patients we followed up in our clinic for invasive meningococcal disease (IMD). Material and Methods: In this retrospective study, records of 26 children with IMD who were followed in the Pediatric Infectious Diseases Clinic of Selcuk University Faculty of Medicine between January 2013 and December 2022 were evaluated. The patients were divided into two groups as <= 5 years and >5 years, and their laboratory and clinical findings were compared. Microbiological examinations of the patients, serotypes, mortality and morbidities were evaluated. Results: Median age of the patients was 45.5 (min-max= 1-203) months and 61.5% (n= 16) were males. Fever was present in all patients. Nausea-vomiting (84.6%), restlessness (80.8%), rash (53.8%), tachypnea and nuchal rigidity (46.2%), tachycardia (n= 42.3%) were the most common clinical findings. While N. meningitidis was shown in microbiological examinations in 88.4% of the patients, clinical diagnosis was made in 11.5% of the patients. Isolated meningitis was 57.7% (n= 15), sepsis and men-ingitis were in 38.5% (n= 10) of the patients. Patients with concomitant arthritis, bronchiolitis, and myocarditis findings were also detected. Isolated pericarditis and pleuritis findings were found in 3.8% (n= 1) of the patients. Cerebrospinal fluid polymerase chain reaction positivity was detected in 69.2% of the patients (n= 18), although there was no growth in the culture. While isolated meningitis was at a higher rate in the age group >5 years (p= 0.005), coexistence of sepsis-meningitis was found at a higher rate <= 5 years (p= 0.014). Fifty percent of the patients were followed up in the intensive care unit. Mortality rate was 7.6% (n= 2), and morbidity rate was 19.2% (n= 5, hearing loss, skin-extremity necrosis, neurologic deficit). Conclusion: There is no routine meningococcal vaccination in our country, so children with fever and poor general condition should be evaluated in detail for meningococcemia. Clinical findings of meningococcemia may develop within hours, therefore children with fever and poor general condition should be closely monitored in the hospital. It should be kept in mind that patients may present with rare clinical findings.