Abstract
Introduction Meningococcal septicemia is not merely an acute disease with a high lethality, but
patients surviving the fulminant phase can suffer from serious long-term sequelae.
Materials and Methods The records of 165 patients admitted to the hospital from 1968 to 2008 with the diagnosis
of meningococcal septicemia were retrospectively reviewed for early signs at presentation,
intensive care management, acute symptoms, the necessity of plastic and orthopaedic
surgical management, and long-term orthopaedic sequelae. Possible predictors of these
conditions were determined.
Results Overall lethality was 17.5%, and mean time of hospitalization time was 28 days. Integument
involvement occurred in 45%, often resulting in the necessity of plastic surgical
procedures. Young age is a significant indicator or skin involvement. Amputations
were necessary in 9% of all cases, affecting the lower extremities more often than
the upper extremities. Six percent of all children suffered from long-term orthopaedic
sequelae, such as growth retardation and angular deformities, appearing up to 11 years
(mean 4.9 years) after onset of the acute disease. The incidence of amputations and
long-term orthopaedic sequelae correlated significantly with severity of the disease.
Conclusion Meningococcal septicemia can entail devastating long-term consequences in children
surviving the acute phase of the disease. Sequelae may become apparent only years
later and cause further damage. To prevent this, a systematic follow-up till adulthood
is necessary.
Keywords amputation - plastic - orthopaedic - adrenal gland failure - meningococcal septicemia
