Hypertoxic form of meningococcal infection: is it possible to save a child’s life? (Clinical case)

Abstract

Meningococcal infection is characterized by an unpredictable course and a high mortality rate. Currently, doctors often have no previous experience of encountering and being wary of the disease. Missed opportunities due to late diagnosis and inadequate treatment significantly increase the likelihood of an unfavorable outcome. The objective of the study was to identify the most typical defects in providing medical care for generalized meningococcal infection based on the analysis of a clinical case of the disease in a young child. As a result of errors at the prehospital stage (ignorance of the peculiarities of the course of infection in children with a typical clinical picture, incorrect diagnosis, underestimation of the severity of the condition, transportation without monitoring vital signs and infusion support) and the initial stage in the hospital (delayed examination in the emergency room, lumbar puncture in the presence of contraindications, late initiation of respiratory support, incorrect tactics of anti-shock therapy), the chance for recovery could have been missed. The child developed critical complications (refractory septic shock, DIC syndrome, multiple organ failure), which led to a fatal outcome within the first day from the onset of the disease. The presented clinical case will help to increase the alertness of doctors to meningococcal infection and improve the quality of medical care. Following clinical recommendations will ensure adequate medical care at all stages, including the development of life-threatening conditions.