Clinical and pathomorphological characteristics of a meningococcal infection with a fatal outcome in young people



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Abstract

To increase the efficiency of medical care for patients with a generalized form of meningococcal infection, clinical manifestations, and pathomorphological changes in young people with a fatal outcome of the disease have been studied. The main clinical form was meningococcemia with fulminant development. The disease was characterized by a sudden onset, rapid progression of typical symptoms: chills, febrile fever, headache, and myalgia. Signs of the development of septic shock were severe hypotension, often vomiting and loose stools. Hemorrhagic exanthema was always detected on the first day of meningococcemia, in some patients - 4-6 hours after the early symptoms. The leading complications and critical conditions in almost all patients with meningococcemia were a septic shock, disseminated intravascular coagulation, and acute adrenal insufficiency. The immediate cause of death was a septic shock (97.1%), in one case, necrotic meningoencephalitis. The timeliness of identifying the first manifestations of a generalized form of meningococcal infection, the provision of emergency care at the prehospital stage, and the speedy hospitalization contribute to maintaining life and health in this category of patients.

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About the authors

K. V Zhdanov

The S.M.Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation

Email: zhdanovkv@rambler.ru
St. Petersburg, Russia

A. N Kovalenko

The S.M.Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation

St. Petersburg, Russia

V. S Chirskii

The S.M.Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation

St. Petersburg, Russia

S. M Zakharenko

The S.M.Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation

St. Petersburg, Russia

N. A Nalivkina

The S.M.Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation

St. Petersburg, Russia

V. V Sharabkhanov

The S.M.Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation

St. Petersburg, Russia

K. S Ivanov

The S.M.Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation

St. Petersburg, Russia

M. K Shishkin

The S.M.Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation

St. Petersburg, Russia

M. V Yaremenko

The S.M.Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation

St. Petersburg, Russia

R. A Khairutdinova

The S.M.Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation

St. Petersburg, Russia

References

  1. Белозеров Е.С., Беляева Т.В., Шувалова Е.П. и др. Менингококковая инфекция / Инфекционные болезни: Учебник для студентов медицинских вузов. - 9-е изд., испр. и доп. - СПб: СпецЛит, 2019. - С. 135-145.
  2. Венгеров Ю.А. Менингококковая инфекция / Инфекционные болезни: Национальное руководство / Под ред. Н.Д.Ющука, Ю.Я.Венгерова. - 2-е изд., перераб. и доп. - М.: ГЭОТАР-Медиа, 2019. - С. 468-483.
  3. Государственный доклад «О состоянии санитарно-эпидемиологического благополучия населения в Российской Федерации в 2018 году». URL: https://www.rospotreb nadzor.ru/ (дата обращения: 09.03.2020).
  4. Жданов К.В., Иванов К.С., Захаренко С.М. и др. Менингококковая инфекция: ранняя клиническая диагностика и неотложная помощь. // Воен.-мед. журн. - 2015. - Т. 336, № 1. - С. 29-35.
  5. Клинические рекомендации. Менингококковая инфекция у взрослых. Менингококкемия. - М.: Кафедра инфекционных болезней и эпидемиологии ГБОУ ВПО «МГМСУ им. А.И.Евдокимова» МЗ РФ, 2015. - 72 с.
  6. Методические рекомендации по профилактике, диагностике и лечению менингококковой инфекции в Вооруженных Силах Российской Федерации. - М.: ГВМУ МО РФ, 2018. - 77 с.
  7. Цинзерлинг В.А., Чухловина М.Л. Инфекционные поражения нервной системы: вопросы этиологии, патогенеза и диагностики: Руководство для врачей / 2-е изд., испр. и доп. - СПб: ЭлБИ-СПб, 2011. - 583 с.
  8. Gentile G., Amadasi A., Bailo P. et al. The importance of the postmortem interval for the diagnosis of Waterhouse-Friderichsen syndrome by Neisseria meningitidis in a series of forensic cases. URL: https://www.revistas.usp.br/autopsy/article / (дата обращения: 25.05.2020).
  9. Hardman J.M. Fatal meningococcal infections: the changing pathologic picture in the “60“s // Mil. Med. - 1968. - Vol. 133. - P. 951-964.
  10. Huang L., Heuer O.D., Janen S. et al. Clinical and economic burden of invasive meningococcal disease: Evidence from a large German claims database // PLoS One. - 2020. - Vol. 15, N 1. URL: https://doi.org/10.1371/journal.pone.0228020. (дата обращения: 25.05.2020).
  11. Olbrich K.J., Muller D., Schumacher S. et al. Systematic Review of Invasive Meningococcal Disease: Sequelae and Quality of Life Impact on Patients and Their Caregivers // Infect. Dis. Ther. - 2018. - Vol. 7, N 4. - P.421-438. doi: 10.1007/s40121-018-0213-2.
  12. Sidorenko S., Zakharenko S., Lobzin Y. et al. Observational study of nasopharyngeal carriage of Neisseria meningitidis in applicants to a military academy in the Russian Federation // Int. J. Infect. Dis. - 2019. - Vol. 81. - P. 12-16. doi: 10.1016/j.ijid.2018.12.012.
  13. Stephens D.S., Apicella M.A. Neisseria meningitidis / Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. Eighth Edition. - Philadelphia: Elsevier, 2015. - P. 2425-2445.
  14. WHO Initiative for Vaccine Research (IVR): Meningococcal disease. URL: http://www.who.int/vaccine_research/ (дата обращения: 09.02.2020).

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