The complications and management of meningococcal meningitis

Abstract

Twenty two cases of meningococcal meningitis admitted to a general hospital in London between 1970 and 1978 have been reviewed. Seven (32%) of the patients died. Unlike previous series, a high proportion of the deaths occured after a protracted illness. Adequate antibiotic treatment was started promptly after admission in almost every case and severely ill patients were admitted to the intensive therapy unit. Various features of the illness at presentation have been reviewed to identify the subjects with a poor prognosis. Neurological deterioration after admission and the development of severe disseminated intravascular coagulation were the best indicators. The modern management of the complications of meningococcal septicaemia has been discussed. It is possible that the late deaths in this series represent patients who would previously have died shortly after admission but whose lives were prolonged by intensive supportive treatment.