title: [Therapy-refractory fulminant meningococcal sepsis].
abstract: Two cases of the severe form of meningococcal infection are described. A 17-year-old girl and a (unrelated) 2-year-old boy suddenly developed fever and rigor. Several hours later petechiae of the skin were noted: they rapidly spread. On admission the girl was found to have a severe consumptive coagulopathy (prothrombin 24%, partial thromboplastin time 104 sec, fibrinogen 73 mg/dl, platelets 35,000/microliters). She died two-and-a-half hours after admission of treatment-resistant shock. The boy had at first only a low prothrombin value (39%), but later the other coagulation values also became abnormal. He died 16 hours after admission from the consumptive coagulopathy and profound anaemia (haemoglobin 7.4 g/dl, haematocrit 0.23). Neither patient had any clinical signs of meningitis. Isolation of Neisseria meningitidis from blood cultures confirmed the diagnosis.
authors.affiliation: Bundesstaatliche bakteriologisch-serologische Untersuchungsanstalt, Universität Innsbruck.
authors.forename: A
authors.initials: A
authors.lastname: Eigentler
authors.forename: P
authors.initials: P
authors.lastname: Lechleitner
authors.forename: C
authors.initials: C
authors.lastname: Wiedermann
authors.forename: H
authors.initials: H
authors.lastname: Fischer
authors.forename: G
authors.initials: G
authors.lastname: Mikuz
authors.forename: M P
authors.initials: MP
authors.lastname: Dierich
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008585:Meningitis, Meningococcal / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology / Q000628:therapy; D009345:Neisseria meningitidis / Q000302:isolation & purification; D011693:Purpura / Q000175:diagnosis / Q000382:microbiology / Q000473:pathology / Q000628:therapy; D012772:Shock, Septic / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology / Q000628:therapy
vernacular_title: Therapierefraktäre fulminante Meningokokkensepsis.