Intensive care of severe and fulminant meningococcal disease in children
Meningococcal disease describes infections caused by the bacterium Neisseria meningitidis (also termed meningococcus). Invasive meningococcal disease remains a rare infectious disease not only with high mortality, but also with important morbidity, and remains a leading cause of sepsis. The Ukrainian epidemiology of meningococcal disease and medical errors of prehospital and emergency treatment were analysed. The most common and effective meningococcal sepsis prognostic scales are evaluated. When meningococcal disease is suspected, treatment must be started immediately and should not be delayed while waiting for investigations. The advanced principles of intensive care for aggressive forms of meningococcal diseases in pediatric patients are observed in this article. Relevant principles of antibacterial therapy, use of fluid resuscitation, inotropes, sympathomimetics and vasodilatators were described in detail. The antibiotics of choice are usually third generation broad spectrum cephalosporins, e.g., cefotaxime or ceftriaxone. Benzylpenicillin and chloramphenicol are also effective. The standard targets of resuscitation were presented. A case report of advanced treatment for meningococcal septic shock in a child was showed. The following methods of intensive care, such as glucocorticoids, fluid and electrolyte disturbance correction, acid-base disorders correction, respiratory support, efferent therapy, skin wound prophylactic and treatment, were characterized in the article.