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PubMed1985

Inherited C8 beta subunit deficiency in a patient with recurrent meningococcal infections: in vivo functional kinetic analysis of C8.

A 16 year old with recurrent meningococcal infections is reported. Absence of haemolytic activity in both the classical and alternative pathways resulted from an absence of functional C8. Addition of functional C8 restored hemolytic activity. Antigenically deficient C8 was present in the serum and isoelectric focusing of serum confirmed the absence of the C8 beta chain. Following the infusion of fresh frozen plasma, we followed the decay in C8 functional activity as well as total haemolytic activity. C8 activity peaked at about 3 h with a half-life survival estimated to be 28 h. The kinetics of total haemolytic activity showed a slower decay with an exponential decline over 72 h and a half-life of 55 h. Fresh frozen plasma may be of value in the treatment of patients with C8 deficiency and acute Neisserial infections.

Adolescent↗
PubMed1992

Meningococcal infections in England and Wales: 1991.

There were fewer reports of cases of meningococcal infection in England and Wales during 1991 than in 1990. The number of isolates received at the Meningococcal Reference Laboratory decreased by 102 (7%), largely due to fewer strains being received from South West Thames, North East Thames and North Western regions. Group C infections showed a greater decrease than group B, with 16% fewer strains reported in 1991 than in 1990. Eight per cent of the strains received during 1991 showed reduced susceptibility to penicillin (MIC > 0.16mg/l).

Adolescent↗
PubMed2003

Treatment of meningococcal infection.

Aggressive early treatment of meningococcal disease can reduce mortality. This relies on prompt recognition and treatment of the complications of septicaemia and meningitis, appropriate ongoing intensive care where necessary, and adequate management of multiple organ failure. Most children with meningococcal disease survive intact, but long term sequelae are increasingly recognised and make follow up essential. New treatments continue to be evaluated, but none has so far proven to be effective in further reducing morbidity or mortality. Simple, timely therapeutic manoeuvres may greatly improve the prospects for survival.

Child↗
PubMed1984

[Bioelectric activity of the brain in hypertoxic forms of meningococcal infection in children].

Children with the generalized form of meningococcal infection aggravated by infectious-toxic shock and brain oedema showed a correlation between symptoms of central nervous system dysfunction and diffuse disturbances of cerebral bioelectrical activity combined with the attenuation of the intercentral relationships of the cortical zones which was most marked in the anterior portions of the left hemisphere. With progressive improvement of the patient, the links between the lobular and temporal zones, especially in the right hemisphere, became stronger which seems to indicate the strengthening of the cortical influence on the limbic diencephalic structures of the brain which activates the child's protective and adaptive reactions.

B-Lymphocytes↗
PubMed1997

Meningococcal infection in Scotland, 1995 to 1997.

The incidence of meningococcal infection in Scotland was 4.1 cases per 100 000 population in 1996 compared with 3.8/100 000 in 1995 (210 cases reported in 1996 compared with 193 in 1995). There were 14 deaths, representing a crude case fatality rate of 6.

Journal Article↗
PubMed1995

Epidemiology of meningococcal infections in children in mid-southern part of Turkey.

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.

Adolescent↗
PubMed1986

Surveillance of meningococcal infections and other forms of purulent meningitis: a 4-year study in the USSR.

The laboratory examination, by microscopic or bacteriological methods and by counterimmunoelectrophoresis, of CSF and blood from 2653 patients with purulent bacterial meningitis, including those with clinically diagnosed meningococcal infection, was carried out between June 1980 and June 1984. The results showed three main etiological agents: meningococci (79.9%), pneumococci (10.8%) and Haemophilus influenzae type b (5.25%). Out of 488 Neisseria meningitidis strains isolated from the CSF or blood, 58.2% belonged to serogroup A, 17.2% to serogroup B, and 14% to serogroup C; infection due to the B serogroup reached nearly 59% among children in 1984. Serotypes were determined in 131 out of 151 strains of Streptococcus pneumoniae and the most frequent were types 1, 19 and 3; type 34, which was isolated from 4 patients, is not a component of the pneumococcal vaccine. The age groups at high risk were children under 5 years old (for meningococcal infection), adults and babies in the first year (pneumococcal meningitis), and children under 3 years, especially between 6 months and 2 years old (H.influenzae type b infection).

Adolescent↗
PubMedDate not supplied

[Kidney morphology in children with meningococcal infection].

The kidneys of 30 children aged 1 month to 5 years who died of meningococcal infection were studied. Three variants of the kidney damage were distinguished on the basis of morphometric parameters. These variants corresponded to the stages of the infectious-toxic shock. The 1st variant observed in the reversible shock stages was characterized by arteriolar spasm and circulation shunts. The 2nd variant corresponded to initial manifestations of the disseminated vascular coagulation and was characterized by a combination of spasm and paralytic arteriola dilatation with a predominant thrombosis of the juxtamedullar glomeruli. The 3rd variant, the stage of the organ alterations, was followed by development of glomerular thrombotic microangiopathy with tubular epithelial necrosis in the proximal tubules this being the morphological counterpart of the hemolytico-uremic syndrome.

Autopsy↗
PubMedDate not supplied

A laboratory review of meningococcal infections in the west of Ireland.

A review of isolates of Neisseria meningitidis and other laboratory evidence of meningococcal infection was carried out for the period 1990-1995. Thirty-three patients with evidence of meningococcal disease were identified over the six year period. Group B organisms were the most commonly identified, but an increase in Group C has occurred and is almost equal in number. Data from clinical, laboratory and public health sources should be centralized in a National Surveillance Centre.

Adolescent↗
PubMed2000

Cyclicity in incidence variations of meningococcal infections in Bulgaria is similar to that of solar activity.

This is a retrospective study on meningococcal meningitis (MM) in Bulgaria that has, for the first time, reported results on non-linear temporal patterns of incidence and its variations. Methods of descriptive statistics, linear and non-linear modelling as well as periodogram regression analysis have been applied. A non-linear decreasing trend in crude incidence rates per 100 persons over the years 1940-1990 has been described (p < 0.0001) and cyclic variations revealed (periods T = 8.00, 18.75, 24.75 and 33.50 years, p < 0.05-0.01). Above cycles have been detected after the reciprocal trend has been removed (y = 1.04 + 15.78/t). A similar cyclicity (periods T = 8.25 and 27.5 years) in the variations of solar activity (sunspot number Rz) over the same time interval of 51 years has been established after the main cycle of 10.5-13 years has been removed by a two-step procedure. The results from this study have added to our previous findings on cyclic variations in mortality and lethality from meningococcal infections in Bulgaria (1, 2). Above similarity is also in accordance with earlier conclusions on relations of solar activity cycles with epidemics of cerebrospinal meningitis in New York and USA over the years 1800-1935 (3, 4).

Bulgaria↗
PubMed1982

[Changes in specific and nonspecific immunity factors in saliva and serum of patients with different clinical variants of meningococcal infection].

Local and humoral immunity factors have been studied in 152 patients with different forms of meningococcal infection. The peculiar pattern of the time course of changes in these factors, depending on the clinical form of the disease, has been revealed. In the generalized form of infection changes in the immunological characteristics of the saliva and blood serum (lysozyme, secretory immunoglobulin, immunoglobulins of the main classes and specific antimeningococcal antibodies) have been shown to be more essential than in the localized form.

Adolescent↗
PubMed1994

[Bacterioscopy of cerebrospinal fluid from patients with generalized forms of meningococcal infection].

The author analyzes the potentialities of bacterioscopic examinations of cerebrospinal fluid samples of patients with meningococcal infection and correlations of the liquor appearance characteristics and bacteriologic data. The findings are extremely important for practical laboratories, for they permit an adequate assessment of bacteriologic examinations and improve their quality. Six CSF groups may be distinguished, differing in their type. A relationship has been revealed between liquor appearance and bacteriologic and bacterioscopic findings, this relationship being prognostically and diagnostically significant.

Adolescent↗
PubMed2004

[Extra-meningeal meningococcal infection: report of 14 cases].

INTRODUCTION AND METHOD: Fifty-five patients (17 adults, 38 children) with meningococcal infection were admitted between 1986 and 2002 in a university hospital (500 beds). Fourteen of them (nine adults, five children) presented with an extra-meningeal infection. We compared adults and children presentations. RESULTS: All adults had immunodeficiency. Septic locations were various (three bacteriemia, four pneumoniae, one infected ascitis, one cutaneous abscess). All patients received amoxicillin or third generation cephalosporin. Hospitalisation was prolonged (mean: 47 days). Seven patients required intensive care unit admission, and two of them died. All children (all were less than 36-month-old) presented with fever. Only one was immunodeficient (infected by human immunodeficiency virus). Neisseria meningitidis grew from blood in four, and in the throat for the remaining one. Hospitalisation was of short duration (mean: 4 days) and none of the children required intensive care unit. All the children recovered rapidly with antibiotics. CONCLUSION: Outcome of extra-meningeal infection with N. meningitidis is different in adults and children. Adults present with immunodeficiency, infection is severe and patients present with various clinical features; children have a more homogeneous clinical presentation (fever) and outcome is excellent.

Adult↗
PubMed1983

Fulminant meningococcal infections in a family with inherited deficiency of properdin.

Three males in a large kindred died of meningococcal infections. In the index patient, properdin (P) was not detectable in serum. Two healthy males with a selective P deficiency were found in the family. There was no general susceptibility to infections, nor to other diseases as suggested by the family history. The serum bactericidal activity for Neisseria meningitidis group C, isolated from the index patient, was moderately reduced in P deficient serum, and was improved by addition of purified P.

Adolescent↗
PubMed1987

Group B meningococcal infection in children during an epidemic in Cape Town, South Africa.

One hundred and thirteen children with meningococcal infection were studied during an epidemic caused by N. meningitidis group B. Fifteen per cent presented with only meningeal symptoms, the remainder showed signs of septicaemia or combined septicaemia and meningitis. Sixteen per cent of the children were in shock and 18% required admission to the Intensive Care Unit (ICU). The mortality was 4.4%. More than half the children were younger than 2 years old. There was no statistical association between the age or nutritional state of the children and any of our measures of severity. A short history of symptoms was more common in children who presented with septicaemia and severe illness, who needed admission to the ICU, or who died. Diagnosis was confirmed by routine bacteriological methods and counter-immuno-electrophoresis (CIE) in 104 children. Eighty-six per cent of the isolates were group B type 2. A history of recent antibiotic treatment was associated with fewer positive cultures, but detection of meningococcal antigen by CIE was not affected by this. CIE antigen detection was not reliable because of the high incidence of false-negative results.

Blood↗
PubMed1991

[Evaluation of the coagglutination reaction with urine in generalized forms of meningococcal infection].

The coagglutination test with concentrated urine was tried in 59 patients with validated generalized forms of meningococcal infection and in 23 ones with meningitides and pneumonia of a different etiology to assess the diagnostic value of this test. Positive results were obtained in 64.4% of the test group patient and in 4.3% of the reference patients (in a case with pneumococcal meningitis). The antigen serologic group in the urine coincided with the serologic group of the meningococcus that induced the disease in only 19 (50%) of the 38 patients in whom antigenuria+ was detected. In the rest cases urine samples reacted parallel with 2-7 antisera, in 5 patients with the antisera heterologic towards the serologic group of the meningococcus responsible for the disease. Antigenuria was observed between the second and ninth days of the illness, its peak was recorded on days 4-6. Repeated urine tests are more likely to yield positive results. The authors come to a conclusion that the test is simple and harmless for patients, but the presence of false positive results permits regarding it as but an auxiliary one.

Agglutination Tests↗