The skeletal consequences of meningococcal septicaemia

Abstract

Meningococcal disease remains a leading cause of childhood mortality in the UK. Advances in resuscitation have resulted in survival of severely affected individuals and the long-term skeletal consequences are being increasingly recognised. The immediate management of the ischaemic limb in the context of a critically ill and haemodynamically unstable child is described and the indications for fasciotomy and amputation are considered. Long-term disability occurs as a consequence of limb malalignment and is often accompanied by significant injury to the soft tissue envelope. The function of surviving limbs can be enhanced using contemporary surgical techniques that involve realignment and lengthening. Amputees present specific difficulties due to the effect of remaining longitudinal growth on the function of the residual limb, and require surgical treatment that often continues throughout childhood. This overview considers the surgical algorithms that have evolved to treat these patients.

Orthopaedic sequelae of meningococcemia in children: options for the correction of lower and upper limb deformities (preliminary message)

“…При этом в доступной литературе нами не найдено сведений о поражении проксимальных зон роста малоберцовых костей. Крайне редким, по данным зарубежной литературы, является поражение проксимальных зон роста бедренных костей [7,10]. Так, F. Fernández et al (1981) зафиксировали только один случай аваскулярного некроза проксимального эпифиза бедренной кости [9], а E. Nectoux et al (2010) приводят два случая аваскулярного некроза головок бедренных костей у пациентов с последствиями менингококковой инфекции.…”

“…Несмотря на то что в достаточно многочисленных зарубежных публикациях эта проблема находит достойное отражение [5][6][7], в русскоязычной литературе мы не нашли сведений, касающихся анализа деформаций конечностей и их коррекции у детей с перенесенной менингококцемией. Учитывая сложившийся информационный дефицит, считаем необходимым рассмотреть вопросы ортопедических последствий менингококковой инфекции у детей в данной публикации.…”

Epidemiological Data, Functional Outcome, and Quality of Life of Patients with Multiple Amputations Due to Septic Shock

“…SPG is also associated with a high rate of multiple limb amputations in 70% to 90% of surviving patients (4,5). Although the clinical characteristics and consequences of septic shock and of PF have been well studied in paediatric populations (6)(7)(8)(9)(10), only few data are available for adult patients and these are often limited to the field of intensive care (11) and the subsequent care of patients. Indeed, data in the literature on the fate of these patients in the years following the acute episode are lacking (12) or limited to a few case reports (10,13,14).…”