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1985. Atypical Symptoms and High Mortality Associated With Serogroup B Meningococcal Disease in Cartagena Colombia 2012–2016
BACKGROUND: Meningococcal disease occurs in an endemic or epidemic form, such as meningitis or meningococcemia, the latter being a fast and high disease, mainly in children. Atypical symptoms have been described by the serogroup W. The aim of this study was to determine the clinical and epidemiologi...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6253192/ http://dx.doi.org/10.1093/ofid/ofy210.1641 |
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author | Coronell-Rodríguez, Wilfrido Arteta-Acosta, Cindy |
author_facet | Coronell-Rodríguez, Wilfrido Arteta-Acosta, Cindy |
author_sort | Coronell-Rodríguez, Wilfrido |
collection | PubMed |
description | BACKGROUND: Meningococcal disease occurs in an endemic or epidemic form, such as meningitis or meningococcemia, the latter being a fast and high disease, mainly in children. Atypical symptoms have been described by the serogroup W. The aim of this study was to determine the clinical and epidemiological characteristics of invasive meningococcal disease (IMD) by serogroup B and the factors associated with mortality in the Cartagena, Colombia between 2012 and 2016. METHODS: Cross-sectional study, carried out from 2012 to 2016 in patients diagnosed with meningococcal disease. Measures of central tendency and dispersion were calculated. A bivariate analysis was performed comparing deceased patients with survivors. RESULTS: From January 2012 to December 2016, a total of 41 cases were reported: one suspected, seven probable, and 33 confirmed cases (all serogroup B), which 73.2% were male, average age 17.9 ± 19.16 years old. Mortality was 39% (16/41), 68.7% (11/16) did it in the first 24 hours. Atypical symptoms were 51.21% (21/41): vomiting 48.7%, myalgias in the lower extremities 36.5%, abdominal pain 19.5% and diarrhea 17.0%, necrotic lesions 12.1%, cyanosis 31.7%, cough 12.1% and rhinorrhea 14.6%. And among the typical symptoms: fever 90.2%, drowsiness 70.7%, purpuric rash 60.9%, headache 53.6%, seizure 14.6%, photophobia 4.8%, psychomotor agitation 21.9%, neck stiffness 29.2% and gait deficit 17.0%. When comparing deceased with surviving cases, significant differences were found in abdominal pain OR 6.0 [1.18–40.27], neck stiffness OR 0.08 [0.009–0.74], meningococcemia OR 8.90, [1.66–47.75] and myocarditis OR 3.08 [1.93 -490), leukocytosis OR 0.22 [IC95% 0.05–0.88]), and PCR OR 0.24 [0.06–0.94]. The most prevalent serotype and sero-subtype was B: 10.15: nt (60.0%). Cluster A, with clonal complex ST-41/44 in 64.3%. CONCLUSION: Atypical gastrointestinal manifestations, besides being described by serogroup W, may also be a form of presentation of serogroup B, related to a higher mortality. DISCLOSURES: All authors: No reported disclosures. |
format | Online Article Text |
id | pubmed-6253192 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-62531922018-11-28 1985. Atypical Symptoms and High Mortality Associated With Serogroup B Meningococcal Disease in Cartagena Colombia 2012–2016 Coronell-Rodríguez, Wilfrido Arteta-Acosta, Cindy Open Forum Infect Dis Abstracts BACKGROUND: Meningococcal disease occurs in an endemic or epidemic form, such as meningitis or meningococcemia, the latter being a fast and high disease, mainly in children. Atypical symptoms have been described by the serogroup W. The aim of this study was to determine the clinical and epidemiological characteristics of invasive meningococcal disease (IMD) by serogroup B and the factors associated with mortality in the Cartagena, Colombia between 2012 and 2016. METHODS: Cross-sectional study, carried out from 2012 to 2016 in patients diagnosed with meningococcal disease. Measures of central tendency and dispersion were calculated. A bivariate analysis was performed comparing deceased patients with survivors. RESULTS: From January 2012 to December 2016, a total of 41 cases were reported: one suspected, seven probable, and 33 confirmed cases (all serogroup B), which 73.2% were male, average age 17.9 ± 19.16 years old. Mortality was 39% (16/41), 68.7% (11/16) did it in the first 24 hours. Atypical symptoms were 51.21% (21/41): vomiting 48.7%, myalgias in the lower extremities 36.5%, abdominal pain 19.5% and diarrhea 17.0%, necrotic lesions 12.1%, cyanosis 31.7%, cough 12.1% and rhinorrhea 14.6%. And among the typical symptoms: fever 90.2%, drowsiness 70.7%, purpuric rash 60.9%, headache 53.6%, seizure 14.6%, photophobia 4.8%, psychomotor agitation 21.9%, neck stiffness 29.2% and gait deficit 17.0%. When comparing deceased with surviving cases, significant differences were found in abdominal pain OR 6.0 [1.18–40.27], neck stiffness OR 0.08 [0.009–0.74], meningococcemia OR 8.90, [1.66–47.75] and myocarditis OR 3.08 [1.93 -490), leukocytosis OR 0.22 [IC95% 0.05–0.88]), and PCR OR 0.24 [0.06–0.94]. The most prevalent serotype and sero-subtype was B: 10.15: nt (60.0%). Cluster A, with clonal complex ST-41/44 in 64.3%. CONCLUSION: Atypical gastrointestinal manifestations, besides being described by serogroup W, may also be a form of presentation of serogroup B, related to a higher mortality. DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2018-11-26 /pmc/articles/PMC6253192/ http://dx.doi.org/10.1093/ofid/ofy210.1641 Text en © The Author(s) 2018. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Abstracts Coronell-Rodríguez, Wilfrido Arteta-Acosta, Cindy 1985. Atypical Symptoms and High Mortality Associated With Serogroup B Meningococcal Disease in Cartagena Colombia 2012–2016 |
title | 1985. Atypical Symptoms and High Mortality Associated With Serogroup B Meningococcal Disease in Cartagena Colombia 2012–2016 |
title_full | 1985. Atypical Symptoms and High Mortality Associated With Serogroup B Meningococcal Disease in Cartagena Colombia 2012–2016 |
title_fullStr | 1985. Atypical Symptoms and High Mortality Associated With Serogroup B Meningococcal Disease in Cartagena Colombia 2012–2016 |
title_full_unstemmed | 1985. Atypical Symptoms and High Mortality Associated With Serogroup B Meningococcal Disease in Cartagena Colombia 2012–2016 |
title_short | 1985. Atypical Symptoms and High Mortality Associated With Serogroup B Meningococcal Disease in Cartagena Colombia 2012–2016 |
title_sort | 1985. atypical symptoms and high mortality associated with serogroup b meningococcal disease in cartagena colombia 2012–2016 |
topic | Abstracts |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6253192/ http://dx.doi.org/10.1093/ofid/ofy210.1641 |
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