title: Meningococcal septic shock in children: clinical and laboratory features, outcome, and development of a prognostic score.
abstract: The clinical characteristics of and outcome for 75 children with meningococcal septic shock were studied. In addition, a new prognostic scoring system was developed. The median age of the patients was 3.2 years (range, 3 weeks to 17.9 years). The most common phenotype of Neisseria meningitidis was B:4:P1.4 (27%). A mortality rate of 21% was observed. Ten (17%) of the 59 survivors had serious sequelae. Calcium levels were significantly lower in patients with seizures. Disseminated intravascular coagulation occurred in 58% of the patients who were tested. Logistic regression analysis identified four laboratory features independently associated with mortality: serum C-reactive protein level, base excess, serum potassium level, and platelet count. These features were used to develop a novel scoring system with a predictive value for death and survival of 71% and 90%, respectively. The outcome was predicted correctly for 86% of the patients, which is higher than rates previously reported for scoring systems.
authors.affiliation: Department of Pediatrics, Sophia Children's Hospital, Erasmus University, Rotterdam, the Netherlands.
authors.forename: R F
authors.initials: RF
authors.lastname: Kornelisse
authors.forename: J A
authors.initials: JA
authors.lastname: Hazelzet
authors.forename: W C
authors.initials: WC
authors.lastname: Hop
authors.forename: L
authors.initials: L
authors.lastname: Spanjaard
authors.forename: M H
authors.initials: MH
authors.lastname: Suur
authors.forename: E
authors.initials: E
authors.lastname: van der Voort
authors.forename: R
authors.initials: R
authors.lastname: de Groot
mesh_terms: D000293:Adolescent; D000471:Alkalosis / Q000209:etiology; D002097:C-Reactive Protein / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D004211:Disseminated Intravascular Coagulation / Q000209:etiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D008589:Meningococcal Infections / Q000097:blood* / Q000150:complications / Q000401:mortality; D009345:Neisseria meningitidis / Q000145:classification; D009426:Netherlands / Q000453:epidemiology; D010976:Platelet Count; D011188:Potassium / Q000097:blood; D011379:Prognosis; D012772:Shock, Septic / Q000097:blood* / Q000150:complications / Q000401:mortality
chemical_list: D002097:C-Reactive Protein; D011188:Potassium