title: Early prognostic indicators in acute meningococcemia: implications for management.
abstract: Three pediatric patients presenting with fever and petechiae with unexpected rapid development of shock are reported. Clinical and laboratory parameters which may identify patients at risk for rapid deterioration are presented. The pathophysiology of meningococcal disease is discussed with emphasis on the possible implications in management. Patients identified at increased risk should be monitored closely; cardiovascular decompensation should be treated aggressively with fluids, pressors, and steroids in an attempt to reverse this process.
mesh_terms: D002675:Child, Preschool; D002701:Chloramphenicol / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004298:Dopamine / Q000627:therapeutic use; D004630:Emergencies; D004837:Epinephrine / Q000627:therapeutic use; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D008297:Male; D008585:Meningitis, Meningococcal / Q000628:therapy; D008589:Meningococcal Infections / Q000628:therapy*; D008775:Methylprednisolone / Q000627:therapeutic use; D009345:Neisseria meningitidis; D011379:Prognosis; D012151:Resuscitation; D018805:Sepsis / Q000628:therapy*; D012772:Shock, Septic / Q000628:therapy
chemical_list: D002701:Chloramphenicol; D004298:Dopamine; D008775:Methylprednisolone; D004837:Epinephrine