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Prognosis of meningococcal disease

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

It is important to recognise the patients who will progress from a non specific early presentation to severe disease since failure to initiate treatment rapidly will be fatal with the majority of deaths occurring in the first 24 hours (before specialist intervention) (1).

In early childhood, meningococcal disease is the leading infectious cause of death

  • it can be fatal within hours of the first symptoms appearing
  • the case fatality rate is about 10% (2)

The worst prognosis is said to be in patients who present with septic shock without meningitis (3).

Death in few people (with meningitis) is caused by raised intracranial pressure but the majority of deaths in meningococcal disease are due to shock or multi organ failure (3)

  • meningococcal septicaemia may progress rapidly to shock and circulatory collapse and the deterioration can be irreversible (4)

Features which predict poor prognosis at the time of presentation:

  • presence of shock
  • absence of meningism
  • rapidly progressive purpuric rash
  • low peripheral white blood cell count
  • thrombocytopenia
  • markedly deranged coagulation
  • depressed conscious level (3)

Reference:

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