Retinal hemorrhages in meningococcal septicemia.
OBJECTIVE
Meningococcal septicemia is associated with coagulopathy and hemorrhagic tendency. We carried out this study to determine the incidence of retinal hemorrhages in meningococcal septicemia.


METHODS
This was a prospective study involving all children admitted to the Sheffield Children's Hospital, Sheffield, England, with a diagnosis of meningococcal septicemia. Confirmation of meningococcal infection was by blood culture or DNA analysis using polymerase chain reaction. The children underwent ocular examination including dilated fundus examination by direct and indirect ophthalmoscopy. Details of their coagulation status were also obtained.


RESULTS
Twelve children (mean age, 4.5 years) with a confirmed diagnosis of meningococcal septicemia were included. All children had coagulopathy. Retinal hemorrhages were found in 5 children (42%). The disease was fatal in 3 children. Group C meningococcus was responsible for the infection in all those with retinal hemorrhages and those with fatal outcome.


CONCLUSIONS
Retinal hemorrhage is a common feature in meningococcal septicemia. Ophthalmic evaluation should be part of the assessment of children with meningococcal septicemia. Future studies on meningococcal disease should include retinal hemorrhage as another parameter in the assessment. This should help us to understand the role of retinal hemorrhage in the prognosis of this serious disease.
Dinakaran
Subramanian
S
Department of Ophthalmology, Royal Hallamshire Hospital, Sheffield, England.
Chan
Tin K J
TK
Rogers
Neil K
NK
Brosnahan
Donal M
DM
D016470:Bacteremia / Q000150:complications*; D002675:Child, Preschool; D004269:DNA, Bacterial / Q000032:analysis; D006801:Humans; D015994:Incidence; D008589:Meningococcal Infections / Q000150:complications*; D009345:Neisseria meningitidis / Q000235:genetics / Q000302:isolation & purification; D009887:Ophthalmoscopy; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D012166:Retinal Hemorrhage / Q000175:diagnosis / Q000209:etiology*
D004269:DNA, Bacterial