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An Immediate Indicator of Prognosis

CPT Warren H. Toews, MC; COL James W. Bass, MC

Am J Dis Child. 1974;127(2):173-176.

Abstract
Of 151 patients studied with meningococcal infection, 14% had no skin lesions, 75% had generalized maculopapular or petechial lesions, and 11% had peripherally located purpuric or ecchymotic lesions. Patients with no skin lesions or those with generalized macular or petechial lesions had a greater incidence of associated meningitis but less fulminant infection. Shock and coagulation factor deficiencies and/or bleeding diathesis (DIC) were rare in these patients and mortality was low (3%). Patients with peripheral purpuric or ecchymotic skin lesions had a high incidence of fulminant infection with little or no meningeal involvement. Shock, DIC, or both were present in most and the mortality was high (44%). The presence, type, and location of skin lesions in meningococcal infection can, thus, be used as an immediate indicator of prognosis.

Author Affiliations
USA; USA, Honolulu

From the Department of Pediatrics, Tripler Army Medical Center; and the Department of Pediatrics, University of Hawaii School of Medicine, Honolulu.

Footnotes
Received for publication Feb 21, 1973; accepted Aug 8.

Reprint requests to Box 243, Tripler Army Medical Center, APO San Francisco 96438 (Dr. Bass).

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