Orthopaedic Sequelae of Meningococcal Septicemia

Abstract

The records of 143 patients admitted with a diagnosis of meningococcal septicemia were reviewed to identify vascular, cutaneous, and osseous sequelae. During the acute phase of the disease there were 21 deaths and 17 patients lost tissue. Thirty-six digits were allowed to autoamputate and six surgical amputations were performed. Each of the latter developed physeal growth arrests proximal to the level of amputation. Four patients underwent fasciotomies for compartment syndrome. Two of these patients had absent distal pulses and at surgery were found to have nonviable limb segments; the authors conclude that fasciotomy is rarely indicated. Sixteen patients were identified with a total of 41 growth arrests. Twenty-three of these occurred under areas of cutaneous scarring and were diagnosed 2 to 9 years after the index admission. The authors believe that patients requiring débridement and/or skin grafting of areas of skin necrosis should be reviewed regularly during the growth period to identify physeal damage at a stage when less complex surgery may be indicated.

Self-Esteem in Children and Adolescents After Septic Shock Caused by Neisseria meningitidis: Scars Do Matter

“…MSS may result in somatic sequelae such as scars, amputation(s) of digit(s) or limb(s) as a result of skin necrosis, and limited motor functioning because of these amputations and orthopedic sequelae [2][3][4][5][6]. We hypothesize that such sequelae can have a negative influence on the self-esteem of child and adolescent survivors of MSS.…”

The Orthopaedic Consequences of Childhood Meningococcal Septicaemia

“…Previous studies investigating the orthopaedic consequences of childhood meningococcal septicaemia have considered an unselected population [13][14][15][16][17][18][19][20][21][22][23]. As such, they are unable to give accurate demographic data.…”

“…Distal tibial physeal arrest has previously been reported as a consequence of meningococcal septicaemia in children [13,15,[20][21][22][23]. It has been suggested that the distal tibial physis is usually incompletely damaged, with the medial tibial physis most often involved, leading to partial growth arrest and asymmetrical development [21].…”

“…Data from Melbourne, Australia between 1985 and 2002 on the management and outcomes of 143 patients with meningococcal sepsis noted a mortality rate of just under 15% [13]. Their study predated the introduction of the meningococcal C vaccine to the National Immunisation Program in 2003.…”

Uso de Terapia VAC® en paciente pediátrico con exposición ósea postamputación tras púrpura fulminans

“…(3) Entre el arsenal terapéutico disponible para tratar las lesiones secundarias a esta patología se encuentran los colgajos microvascularizados y los injertos cutáneos. Se contempla también el uso de piel artificial o sustitutos cutáneos hasta plantear la cobertura con autoinjertos, que a veces están limitados por la superficie corporal total del paciente (4,5).…”