The changing presentations of meningococcal disease

Eur J Pediatr. 1995 Jun;154(6):472-4. doi: 10.1007/BF02029358.


Meningococcal disease (MCD) can present as meningitis, meningitis plus septicaemia or septicaemia alone. This 17-year retrospective study sought to determine if the proportion of cases presenting as septicaemia alone was increasing. Four hundred and forty-nine children with MCD were admitted between 1977 and 1993, 50 children died (11%). The proportion of cases with septicaemia alone increased from 7% in 1977-1985 to 36% in 1990-1993 (P < 0.0005). Mortality was highest in children with septicaemia alone (19%). Despite the increase in septicaemia, overall mortality did not alter over the 17 years.

Conclusion: MCD should not be thought of as "meningitis", since 33% of cases now present as septicaemia alone. Nearly one in five children with septicaemia alone die. Information and publicity about MCD should focus on septicaemia, characterised by a petechial rash, as the life-threatening presentation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bacteremia / complications
  • Bacteremia / epidemiology*
  • Bacteremia / mortality
  • Chi-Square Distribution
  • England / epidemiology
  • Humans
  • Infant
  • Meningitis, Meningococcal / complications
  • Meningitis, Meningococcal / epidemiology
  • Meningitis, Meningococcal / mortality
  • Meningococcal Infections / complications
  • Meningococcal Infections / epidemiology*
  • Meningococcal Infections / mortality
  • Retrospective Studies
  • Severity of Illness Index