Adult overwhelming meningococcal purpura: a study of 35 cases, 1977-1989

Article Abstract:

Overwhelming infectious purpura, or adult overwhelming meningococcal purpura, is characterized by circulatory shock (inadequate return of blood to the heart), purpuric lesions (local hemorrhages into tissues), and hemorrhage in the adrenal glands. Mortality was once almost 40 percent, and survivors were often impaired. The disease was first described during the last century, but only when the sulfonamide drugs became available in 1936 could it be cured. Mortality fell to under four percent among the military during World War II, but it remains just under 20 percent among civilians today. This study of 35 patients indicated that a low level of fibrinogen (a blood clotting factor) was the only measurement that predicted death with accuracy. Mortality in this group was 54 percent. The duration of shock and speed with which antibiotic therapy is begun have not been studied as clinical indicators of outcome before. This study found that length of shock and late administration of antibiotics did not indicate a poor outcome; however, timing of antibiotic therapy was not available for all cases. Meningococcal infections in children and teenagers occur primarily in the winter and early spring, but adult overwhelming meningococcal purpura occurs throughout the year. Symptoms may include digestive upset or flu-like illness, or a rash, but a high fever is always present. Lumbar puncture to evaluate infection of the cerebrospinal fluid is risky and may not be useful for diagnosing the disease in children, but is usually fast, safe, and clearly diagnostic when performed on adults. Treatment for shock is a major problem, and initial heart failure has occurred among children and adults. About half of survivors end up with circulatory problems. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Causes of, Purpura (Pathology), Purpura

---

A cluster of meningococcal disease on a school bus following epidemic influenza

Article Abstract:

A report is presented of an outbreak of invasive meningococcal disease (inflammation due to infection by Neisseria meningitidis) in five children who rode the same school bus. All five children survived the disease, which affected the meninges (membranes surrounding the brain and spinal cord) in three children and the blood in two children. The bus, which held a maximum of 66 passengers, transported 72 students each day to a preschool, an elementary school, a middle school, and a high school. Four middle-school children and one elementary-school child became ill. Before the outbreak, an unusually large proportion of children had been absent from school at all levels because of respiratory infections due to influenza. The five affected children had had influenza-like symptoms several weeks previously. After the outbreak, rifampin (an antibiotic) was given as a preventive measure to all who rode the school bus, and a meningococcal vaccine was administered to 1,200 people in the schools attended by the children. It is likely that upper respiratory tract infections predisposed these children to meningococcal disease; the mechanisms by which this can occur are discussed. However, risk factors for that disease could not be identified because the number of cases was small and rifampin had been given. (Consumer Summary produced by Reliance Medical Information, Inc.)

Reports, Complications and side effects, Demographic aspects, Influenza, Communicable diseases in children, Pediatric communicable diseases

---

Gender and survival after AIDS in Rio de Janeiro, Brazil

Article Abstract:

Brazilian women with AIDS may have a poorer prognosis than men. Researchers studied survival rates among 617 HIV-infected Brazilians, of whom 124 developed AIDS during the study. Ninety-one were men and 33 were women. Although men and women were equally likely to receive treatment, women had shorter life spans. More research is needed to determine why these women die sooner than men.

Patient outcomes, Mortality, Brazil, Sex factors in disease, Disease sex factors, AIDS (Disease), Brazilians

Similar abstracts:

• Abstracts: Appendectomy during pregnancy: a Swedish registry study of 778 cases. part 2 Perinatal outcome following improvement of abnormal umbilical artery velocimetry
• Abstracts: Primary adenocarcinoma of the jejunum and ileum: clinicopathological review of 25 cases. Primary squamous cell carcinoma of the terminal ileum
• Abstracts: The impact of long-term warfarin therapy on quality of life: evidence from a randomized trial. Lovastatin-warfarin interaction

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.