59 patients were treated for meningococcal infections in Cukurova University Faculty of Medicine, Division of Pediatric Infectious Diseases. 50.8% of patients were male, 33.9% were under two years of age and 61% were under five. 78% of patients were admitted to hospital in winter and spring time. Meningococcal meningitis (MM) was present in 39% of patients on admission, however, meningococcemia in 27.1% and meningococcemia and meningococcic meningitis (Meningococcemia + MM) in 33.9%. Fatality rate was 18.6% and no association was found between mortality and clinical type of disease (p > 0.05), but mortality ratio decreased with an increasing age (p < 0.01). No deaths occurred among the 12 patients who received i.v. penicillin treatment shortly before admitting to hospital, on the other hand 11 of 47 patients (23.4%) without such a previous treatment died.
PIP: The clinical and laboratory findings of 59 patients treated for meningococcal disease between January 1, 1989, and December 31, 1993, in Adana, Turkey's Cukurova University, Faculty of Medicine, Division of Pediatric Infectious Diseases were analyzed retrospectively. The diagnosis was based on clinical findings, positive blood or cerebrospinal fluid (CSF) cultures, and the presence of gram negative diplococci in the CSF and in the smears from petechiae. Of 59 patients, 29 (49.2%) were female and 30 (50.8%) were male, with ages ranging from 1 month to 14 years. 20 (33.9%) patients were in the 0-2 and 36 (61%) were in the 0-5 age group. Most of the patients (45.7%) were admitted to the hospital in the winter, followed by spring (32.2%), summer (15.3%), and fall (6.8%). In January and February there seemed to be a peak in admission rates (18.6% and 16.9%, respectively). The distribution of patients with respect to seasons showed a statistically significant difference (p .0001). The overall case fatality was 18.6% (11/59). Meningococcal meningitis (MM) was diagnosed in 23 (39%) patients, meningococcemia in 16 (27.1%), and MM + meningococcemia in 20 (33.9%). 10 of 20 children 0-2 years of age presented with meningococcemia alone. On the other hand, 11 (47.8%) of the 23 patients over 5 years showed MM alone. Clinical presentation revealed a significant association with certain age groups (p .05). Fatality ratios in children under 2 years old and in children 2-14 years old were 35% and 10.2%, respectively, and there was a significant trend for decreasing case fatality rate with increasing age (p .01). All patients aged 0-3 months died. The fatality rate was the lowest among patients over 5 years of age (8.7%, 2/23). The mortality rate did not change with clinical presentation (p .05). Two patients (8.7%) with MM died, while this rate was 20% (4/20) in patients with MM + meningococcemia. 5 of 16 (31.3%) patients died in the group with meningococcemia only. Signs of upper respiratory tract infection were present in 11 (18.6%) patients during their initial physical examination, but no statistically significant relationship was found in respect to mortality (p .05).