[Neurological sequelae of the generalized forms of meningococcal infection in adults (a catamnestic study of patients who suffered the disease during 1971--1974)]. / Nevrologicheskie posledstviia generalizovannykh form meningokokkovoi infektsii u vzroslykh (katamnesticheskoe obsledovanie bol'nykh, perenesshikh zabolevanie v 1971--1974 gg)

The authors conducted a follow-up examination of 118 patients who had meningocaccial meningoencephalitis and meningitis in 1971--1974. Besides a neurological examination the authors performed psychological and EEG studies. It was established that the main expressions of the meningococcial infection during the first 2--3 months following the acute period (and in separate cases up to 1 year and more) were: asthenical syndromes of a different degree, diffuse focal symptoms, neuritis of the cranial nerves, distrubed mental activity and changes in the EEG. For these reasons the estimation of the period of restored working capacity after generalized forms of meningococcical infections should always be strictly individual.

[Experience with the use of aminalon in the complex treatment of children with meningococcal infections]. / Opyt primeneniia aminalona v kompleksnoi terapii meningokokkovoi infektsii u detei.

The results of using the Soviet drug aminalon in combined therapy of 143 children aged 7 months to 16 years suffering from generalized meningococcal infection are presented. According to the data of catamnestic observation the use of the drug in the early convalescence period contributed to a reduction of the incidence of residual manifestations in the patients, and prevented development of the cerebrospinal syndrome. In the late restorative period, the repeated courses of aminalon in combination with vitamins and other biostimulants are indicated in children with asthenohypodynamic states or having difficulties of learning at school.

Costs of surviving meningococcal disease in Spain: evaluation for two cases of severe meningitis and septicaemia.

OBJECTIVES: The aim of this study was to count the lifelong rehabilitation costs associated with surviving meningococcal disease with major sequelae from the perspective of the Spanish National Healthcare System (NHS) and the national government. METHODS: Two severe scenarios describing meningococcal disease were developed, one case that represented meningococcal septicaemia and another case for meningococcal meningitis. The scenarios were developed based on a literature review on severe sequelae of meningococcal disease, and discussions with paediatricians who have been responsible for the treatment of children with this disease in Spain. Second, a detailed list of all health, educational and social care resources used by survivors during their acute illness and during the rest of their lives and by family members was obtained by interviewing survivors and their families. Professionals in health and social care were also interviewed to complete the list of resources and ensure the scenario's were accurate. The costs attributed to these resources were obtained from tariff lists, catalogues and published information by the national authorities. All costs were based on a life expectancy of a survivor of 70 years and expressed in EUR 2012. RESULTS: In this study it was estimated that the lifelong discounted rehabilitation costs associated with the treatment of long-term sequelae due to meningococcal disease are approximately €1180,000-€1400,000. Medical care and social care were the main cost drivers for both septicaemia and meningitis. Annual costs showed to be the largest in the first year after diagnosis of the disease for both cases, due to high hospital admission and medical care costs during this period and decreased significantly over the years. CONCLUSION: This study shows that the lifelong rehabilitation costs associated with the survival of meningococcal disease with severe sequelae place an important burden on the NHS budget and governmental resources in Spain.

Long-term health status in childhood survivors of meningococcal septic shock.

OBJECTIVE: To assess long-term health status in patients who survived meningococcal septic shock in childhood. DESIGN: Medical and psychological follow-up of a cross-sectional cohort. SETTING: Pediatric intensive care unit (PICU) of a tertiary care university hospital. PARTICIPANTS: All consecutive patients with septic shock and purpura who required intensive care between 1988 and 2001. Intervention Patients and their parents were invited to our follow-up clinic 4 to 16 years after PICU discharge. OUTCOME MEASURES: Health status was assessed with a standard medical interview, physical examination, renal function test, and the Health Utilities Index Mark 2 (HUI2) and 3 (HUI3). RESULTS: One hundred twenty patients (response rate 71%) participated in the follow-up (median age at PICU admission, 3.1 years; median follow-up interval, 9.8 years; median age at follow-up, 14.5 years). Thirty-five percent of patients had 1 or more of the following neurological impairments: severe mental retardation with epilepsy (3%), hearing loss (2%), chronic headache (28%), and focal neurological signs (6%), like paresis of 1 arm. One of the 16 patients with septic shock-associated acute renal failure at PICU admission showed signs of mild chronic renal failure (glomerular filtration rate, 62 mL/min/1.73 m(2); proteinuria; and hypertension). Scores were significantly lower on nearly all HUI2 and HUI3 attributes compared with Dutch population data, indicating poorer health in these patients. CONCLUSIONS: In patients who survived meningococcal septic shock in childhood, one-third showed long-term neurological impairments, ranging from mild to severe and irreversible. Patients reported poorer general health as measured by HUI2 and HUI3.

Rehabilitation of a child with meningococcal septicemia and quadrilateral limb loss: a case report.

Acquired quadrilateral limb loss is a rare occurrence in children. One cause of this condition is severe meningococcal septicemia. We present the case of a boy who, at 14 months of age, required extensive amputation after an episode of meningococcal septicemia. We review his medical recovery and rehabilitation, including upper- and lower-limb prosthetic prescription and training, and adaptation to his altered body. A multidisciplinary approach led to effective management of his complex clinical and psychologic needs. This case illustrates the need to address a range of medical, prosthetic, and family issues central to successful clinical outcome.