Diagnosis and features of the clinical course of meningococcal infection in Transcarpathia

November 2, 2021
Specialities :

Objective: to establish the main clinical and laboratory features of generalized forms of meningococcal infection (MI).

Materials and methods. 33 medical cards of inpatients who were treated generalized forms of meningococcal disease (MD) for the period 2016–2018 were selected.

Results. The pathognomonic symptom of meningococcemia — hemorrhagic rash, was present in only 41% of patients. Body temperature in most patients with meningococcemia (ME) was normal (45%) or subfebrile (38%), which is not typical for the classic course of ME. 22% of patients with ME and 60% with mixed MD at the beginning of the disease had vomiting. All patients with mixed MD and meningococcal meningitis (MM) had positive meningeal symptoms. Erythrocyte sedimentation rate in persons with ME was 9±3, MM — 11, with the mixed form of MD — 35±5 mm/hr. Leukocytosis was observed in 45% of patients with ME, in 80% with mixed and in 1 patient with MM. Bacterioscopic method («thick drop» of blood method) was positive in 20 (74%) patients with ME and in 3 (60%) with mixed form MD (ME with MM). This method was confirmed by a pure culture of Neisseria meningitidis in 1 of 20 patients (4%) with positive blood microscopy (ME) and in all patients with a mixed form of MD.

Conclusions. The clinical course of ME in patients is atypical: the absence of fever (45%) and typical hemorrhagic rashes (59%). Among the results of paraclinical studies should be noted the absence of leukocytosis in 55% of patients. Specific diagnostic methods (bacteriological and bacterioscopic) have low efficiency for verification of the pathogen, due to low sensitivity (bacteriological method) and specificity (bacterioscopic method). These methods should be replaced by serological, such as latex agglutination methodand molecular genetic (polymerase chain reaction).


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