Journal Article

Meningococcal disease and its management in children

Thomson, Alistair P J, Hart, C Anthony

2006

Overview

In the meningitis belt of sub-Saharan Africa, meningococcal disease presents predominantly as meningitis alone. 2 Meningococcal infection What causes it The meningococcus is solely a human pathogen, and up to 50% of the population may carry meningococci in the nasopharynx. 3 w1 Factors that lead to invasion and production of disease include complex inter-relationships of genetic predisposition, host status, environmental conditions, and virulence of the organism. 4 w2 Literature searches We searched Medline in May 2006 (PubMed, since 1966, except where stated) with the terms meningococcus, meningococcal infection, meningococcal disease, meningococcal disease and predisposition (English, reviews, past 5 years), meningococcal disease and carriage (English, reviews, past 5 years), meningococcal disease and symptoms, meningococcal disease and signs, meningococcal disease and treatment, meningococcal disease and outcome, and meningococcal disease and prevention. (Most general practitioners will see thousands of children with non-specific, non-blanching rashes for every child presenting with meningococcal disease.\\n Improvements in outcome are likely to have resulted from multiple factors. 26 w7 Among survivors, 10% have deafness, 10% have neurodevelopmental sequelae such as cerebral palsy, and 5% have more subtle neurodevelopmental abnormalities. 27 Over the past 15 years, improved recognition and earlier treatment may have led to a higher survival rate, although data need to be examined carefully,w8 but with the emergence of \"survival at a cost\" peripheral amputations especially have increased.

• Publisher: British Medical Journal Publishing Group,British Medical Association,BMJ Publishing Group LTD,BMJ Group
• Subject: Anti-Bacterial Agents - therapeutic use / Blood / Cerebral palsy / Child / Children / Children & youth / Clinical Review / Epidemiology / Exanthema / Hospitalization / Humans / Infections / Intensive care / Meningitis / Meningococcal Infections - diagnosis / Meningococcal Infections - etiology / Meningococcal Infections - therapy / Meningococcal meningitis / Neisseria meningitidis / Nervous system diseases / Notifiable diseases / Osteonecrosis / Patient Education as Topic / Physical Examination - methods / Preventive medicine / Prognosis / Respiration, Artificial / Septic shock / Vaccines / Viral infections