Abstract
In order to asses the clinical forms of meningococcal disease, we reviewed 201 cases diagnosed as meningococcal disease in the University Hospital of the Fluminense Federal University in Rio de Janeiro, 185 of which met the inclusion criteria. Clinical and laboratorial characterization allowed for grouping of the cases as follows: meningococcal meningitis, 18%; meningitis with septicemia, 62%; and septicemia, 20%. Available epidemiological data did not differentiate clinical forms. The following were significantly greater in meningococcal meningitis: duration of clinical history; frequency of neurological manifestations; positive bacterioscopy; culture and latex test in cerebrospinal fluid. The following were significantly predominant in septicemia: shock; fatal outcome and higher partial thromboplastin time. Septicemia and meningitis with septicemia were differentiated from meningococcal meningitis in the following: duration of clinical history; occurrence of focal neurological signs; disseminated intravascular coagulation; and arthritis. Clinical and laboratory data lead us to admit meningococcal meningitis as a localized form of Meningococcal disease, and meningitis with septicemia and septicemia as variations in severity of the systemic form of the disease.
Highlights
In order to asses the clinical forms of meningococcal disease, we reviewed 201 cases diagnosed as meningococcal disease in the University Hospital of the Fluminense Federal University in Rio de Janeiro, 185 of which met the inclusion criteria
A idade dos pacientes variou de 2 meses a 60 anos com maior concentração até 14 anos, 132 (71%) casos, e discreto predomínio do sexo feminino, 51% (94/185)
Seu número limitado, surdez (1%) e ataxia (1%), não permitiu diferenciação entre as apresentações clínicas de doença meningocócica (DM)
Summary
Os casos estudados foram admitidos nos Serviços de Doenças Infecciosas e Parasitárias e de Emergência do Hospital Universitário Antônio Pedro, UFF, no período de 1971 a 1996, e submetidos, então, à rotina regular de atendimento. Não se observou associação significativa entre tempo médio mais curto de duração de internação e as formas clínicas, que variou entre 156 horas (DM-S) e 248 horas (DM-M). Esplenectomia (2), esplenectomia por esquistossomose (2), esquistossomose (2), anemia falciforme (1), diabetes mellitus (1), droga-adição (1), púrpura trombocitopênica (1), linfoma de Hodgkin (1), meningite prévia (1), esquistossomose + sarampo (1), alcoolismo (1), cirrose (1) e síndrome de Down (1) - foram registradas em 9% (16/185) dos casos, sem diferença estatística entre DM-MS e DM-S, porém com predomínio significante na DM-S frente à DM-M (p
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