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[The activity of natural killers and K cells and their interferon sensitivity in subjects inoculated against diphtheria and meningococcal infection].

The work deals with the time course of changes in the activity of natural killers, K-cells, their sensitivity to interferon, which reflects, in our opinion, the reserve possibilities of this killer system simultaneously with the development of the specific sensitization of lymphocytes. Significant changes in the cytotoxicity of natural killers, K-cells, have been detected in persons immunized against meningococcal infection, especially in those immunized with meningococcal vaccine introduced in combination with diphtheria toxoid. In this latter group of volunteers even more pronounced sensitization of peripheral blood lymphocytes has been observed than in persons immunized with monopreparations. The results obtained in this investigation indicate that the determination of these cell reactions may be of importance in the evaluation of the effectiveness of immunization.

Adult↗
PubMed1989

[Enzymologic diagnosis of cerebral lesions in generalized forms of meningococcal infection in the acute period].

Cerebrospinal fluid was tested for several enzymes (CPK, AST, GGTP, BP, BG, AK) in 97 patients with generalized meningococcal infection with prevalent CNS affliction. Marked changes were detected even in the absence of clinical signs of cerebral lesion that was typical only of meningococcemia. Nevertheless, most pronounced changes were observed in a group of patients with cerebral edema and swelling. The changes in cerebrospinal fluid enzyme levels coincided with a reduced glucose and increased protein contents. In these cases, CSF hypertension increased CSF pressure to maximal levels. Most informative indices were singled out and their levels characteristic of acute phase of the disease established.

Adolescent↗
PubMed1989

Trends in mortality in children hospitalized with meningococcal infections, 1957 to 1987.

We reviewed charts of 261 children seen at Children's Hospital of Wisconsin from 1957 to 1987 with culture-proven meningococcemia or meningococcal meningitis, and we analyzed trends in mortality and disease severity for that interval. Overall case fatality was 10%, ranging from 9% in the period 1957 to 1963, to 16% in the period 1980 to 1987 (P = 0.15). The percent of patients admitted with severe disease increased from 14% to 38% (P = 0.001). When stratified by disease severity, case-fatality rates did not change with time. We conclude that technologic advances of the past 30 years had no measurable impact on mortality from meningococcal infection in our hospital and that crude case-fatality rates can be misleading if disease severity is not considered.

Adolescent↗
PubMed1990

[Meningococcal infection and arthritis].

Arthritic manifestations in patients with meningococcal disease are of varied pathogenesis. Four different pathogenic mechanisms may be involved. Direct bacterial invasion of the synovium and multiplication within the joint (septic arthritis); hypersensitivity reaction or allergic arthritis; intra- or periarticular hemorrhage (hemarthrosis) and iatrogen causes, i.e. reaction to antimicrobial agents, serum therapy etc. Four distinct clinical forms have been described: The septic, culture-positive polyarthritis is seen early in the course of the disease. The sterile "non-infectious" or allergic mono- or oligo arthritis are seen later in the course. Primary meningococcal arthritis. Arthritis may be seen in relation to chronic meningococcemia. Treatment consists primarily of specific antimeningococcal chemotherapy, viz penicillin and non-steroid-anti-inflammatory drugs. The prognosis of meningococcal arthritis is excellent and joint sequelae are rare. Predisposing factors in relation to meningococcal disease are reviewed. The most important are socioeconomic conditions, acute respiratory illness, particularly in relation to age as children less than two years are most susceptible, passive smoking, IgA blocking antibodies, the concentration of complement factors C3, C6, C7, C8, and IgG2-defects.

Arthritis, Infectious↗
PubMed1983

[Hypophosphoremia and meningococcal infection. Preliminary study].

Serum phosphorus showing anomaly low values: 2.47 +/- 0.41 mg/dl (p less than 0.001) were determined within the first hours of admittance in 18 children with meningococcal infection. In another 10 renal clearance was performed founding phosphatemias of 2.35 +/- 0.37 mg/dl (p less than 0.002), determining FE of electrolytes. Both groups were compared with another one without infectious pathology which presented normal phosphatemia. Most serious cases had the most severe hypophosphatemia (p less than 0.01); eight children presented hyperphosphaturia up to 52.7 mg/Kg/day and TRP lower than 80%; six asymptomatic hypocalcemia, two hypomagnesemia; FE of potassium was elevated in three children, FE of calcium in one child and FE phosphorus in eight children. Monosodium phosphate was administered to two children with myocarditis as they presented signs of hypophosphatemia. All of them normalized biochemically in 3-4 days. Possible physiopathological mechanisms of this situation are discussed, considering the possibility that hormonal and/or tubular mechanisms take part in the lowering of phosphorus. Necessity of monitoring serum and urine phosphorus in these children is emphasized.

Child, Preschool↗
PubMed1999

Should we be doing more to prevent Group C meningococcal infection in school age children? How can we decide?

Meningococcal Group C infections are potentially preventable by vaccination in most cases. Population immunization has not been adopted because the disease is rare and the vaccine effective for only about three years. However, the recent rise in cases in school age children has prompted an assessment of the cost-effectiveness of alternative strategies for management of a case of Group C infection. Chemoprophylaxis and vaccination of close contacts is the most cost-effective strategy but will prevent relatively few cases. Population vaccination prevents considerably more cases, but at a much higher total and marginal cost. An intermediate strategy of giving antibiotics to and vaccinating the school population following a single case, in addition to contact tracing, has intermediate cost-effectiveness. Policy decisions will take into account other important factors but the approach we have taken makes explicit key assumptions so that wider debate including profession and public can be developed.

Adolescent↗
PubMed1984

Myocardial depression in septic shock caused by meningococcal infection.

Comparative hemodynamic measurements recorded in 19 cases of septic shock associated with Neisseria meningitidis bacteremia and in 20 shock cases associated with bacteremia due to other Gram-negative bacilli showed a significantly higher incidence of early myocardial depression in the cases with meningococcal infection. Echocardiographic, ECG, and serum enzyme (CK-MB isoenzyme) studies closely correlated with impaired myocardial contractility and development of cardiogenic shock in patients with meningococcal bacteremia. Autopsy of the heart from three patients who succumbed to shock confirmed the presence of myocarditis with intracellular Gram-negative diplococci. Our observations suggest that the onset of cardiac dysfunction precedes clinical manifestations of shock.

Adolescent↗