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Revista del Instituto de Medicina Tropical

versão impressa ISSN 1996-3696


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.


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


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.


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%).


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.

Palavras-chave : Neisseria meningitidis; meningococcemia; pediatrics-serogroups.

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