SciELO - Scientific Electronic Library Online

 
vol.13 issue1Knowledge, attitudes and practices on medical students in Mayaro virus, 2017 author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand

Journal

Article

Indicators

  • Have no cited articlesCited by SciELO

Related links

  • Have no similar articlesSimilars in SciELO

Share


Revista del Instituto de Medicina Tropical

Print version ISSN 1996-3696

Abstract

AMARILLA, Sara et al. Epidemiology, clinical and prognostic factors of Invasive Meningococcal Disease in a reference center in Paraguay. 2005 to 2018. Rev. Inst. Med. Trop. [online]. 2018, vol.13, n.1, pp.40-53. ISSN 1996-3696.  https://doi.org/10.18004/imt/201813140-53.

Introduction:

Meningococcal disease has been and continues to be an important cause of morbidity and mortality around the world.

Objectives:

To analyze the clinical and epidemiological characteristics of patients with invasive meningococcal infection hospitalized in a reference hospital center.

Materials and methods:

A descriptive, observational and retrospective study based in the review of clinical records of patients admitted between 2005 and 2018 in the Institute of Tropical Medicine in whom Neisseria meningitidis was isolated o detected by PCR in blood or CSF.

Results:

Forty-four patients with invasive meningococcal disease were recruited during the period studied (3 ± 2 cases/year). The cases predominated in the age group <5 years (36% of all cases), with similar gender distribution. Forty-six patients (59%) had meningitis and 18 (41%) meningococcemia, 12 of them (27%) with concomitant meningitis. Forty-three percent of the patients required admission to the ICU. The lethality was 20.5% (9/44), higher in patients with meningococcemia, although without statistical significance (p = 0.16). The presence of shock (p<0.01), the ICU requirement (p=0.001), leukopenia <5000, leukocytes/mm3 (p <0.01), leukocytosis>15000/mm3 (p=0.03), thrombocytopenia<150000/mm3 (p=0.01) and the presence of <100 leukocytes field in CSF (p = 0.02) were factors associated with higher mortality. No association was found between severity and serotypes. When all the years of the study was analyzed, serogroup B was the predominant (50%); however, in the last 3 years all isolates (n = 14) corresponded to serogroups C (n = 10, 71%) and W135 (n = 4, 29%).

Conclusion:

Meningococcal disease presents a stable pattern of endemicity in Paraguay, with a recent increase in cases of serogroup C and W135 Currently the serogroup C constitues more than 70% of the cases. The presence of shock, leukocytosis>15,000/mm3, leukopenia <5000 / mm3, and thrombocytopenia were associated with increased mortality.

Keywords : Neisseria meningitidis; meningococcemia; pediatrics-serogroups.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )