Meningococcemia and Treated With

Abstract

Several publications have recently emphasized the relationship between fulminant meningococcemia and consumption coagulopathy.1-3Patients exhibiting meningococcal infection with intravascular coagulation and consumption of clotting factors have an extremely poor prognosis. Their course is usually characterized by irreversible shock. Treatment of the consumption coagulopathy with heparin has failed to alter the course of the irreversible shock and hemorrhagic tendency.1,2Winkelstein et al3have recently reported successful treatment of three patients with heparin sodium and dextran 70. These patients had laboratory evidence of consumption coagulopathy, but were free of purpura. This report concerns a patient with fulminant meningococcemia, shock, extensive purpura, and consumption coagulopathy, who was successfully treated with heparin and dextran 70. The use of dextran as a volume expander was necessitated by the refusal of the patient, a Jehovah's Witness, to accept transfusions or blood products. In addition, dextran was utilized because of antithrombotic properties which may