[Meningococcal sepsis and DIC in childhood: a report of a clinical case].
Disseminated intravascular coagulation (DIC) is a frequent complication of meningococcal sepsis in children. The clinical course variability, the severity of manifestations and the need of an early diagnosis for appropriate treatment, guides us to report a case of meningococcal sepsis and DIC. The patient, male, prematurely born, 11 months years old, presented himself with high fever of sudden onset, malaise, diarrhea, diffuse skin rash with abdominal petechiae, and no clinical evidence of meningitidis. Initial hematochemical findings, peripheral leukocytosis, quantitative and qualitative changes in plasma coagulation factors, liquoral hypocellularity together with the development of signs of meningeal irritation (stiff neck and back) were considered diagnostic clues for meningococcal sepsis associated with DIC. A gram-negative diplococcus was cultured from liquor. Primary goals of the treatment of this life-threatening clinical picture were the elimination of the bacterial component, the correction of clotting disorders and careful control of shock and metabolic acidosis often related with DIC. The patient then received a wide spectrum Cephalosporin, fresh frozen plasma, appropriate electrolyte solutions and eventually heparin, which led to a complete control and resolution of symptomatology.
Carnelli
V
V
Cattedra di Ematologia Pediatrica, Università di Milano, Italia.
Turconi
A
A
Stucchi
C
C
Giovanniello
A
A
Perri
M
M
Portaleone
D
D
D000138:Acidosis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D003131:Combined Modality Therapy; D004211:Disseminated Intravascular Coagulation / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D006801:Humans; D007223:Infant; D008297:Male; D008589:Meningococcal Infections / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D012772:Shock, Septic / Q000517:prevention & control
Sepsi meningococcica e C.I.D. in età pediatrica: discussione di un caso clinico.