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Published Online First: 8 May 2007. doi:10.1136/adc.2006.104885
Archives of Disease in Childhood 2007;92:790-794
Copyright © 2007 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health.

Original articles

Severity of meningococcal infections is related to anthropometrical parameters

N Perez1, L Regairaz1, J Bustamante1, N Osimani2, D Bergna3, J Morales4, M R Agosti4, S Gonzalez-Ayala4, C Peltzer3, A Rodrigo2

1 Immunology Unit, Hospital de Niños "Sor María Ludovica" and Instituto de Desarrollo e Investigaciones Pediátricas, La Plata, Argentina
2 Nutrition Unit, Hospital de Niños "Sor María Ludovica" and Instituto de Desarrollo e Investigaciones Pediátricas, La Plata, Argentina
3 Intensive Care Unit, Hospital de Niños "Sor María Ludovica" and Instituto de Desarrollo e Investigaciones Pediátricas, La Plata, Argentina
4 Infectious Diseases Unit, Hospital de Niños "Sor María Ludovica" and Instituto de Desarrollo e Investigaciones Pediátricas, La Plata, Argentina

Nestor Perez, Unidad de Inmunología, Hospital de Niños Sor María Ludovica, 14 y 65, La Plata 1900, Argentina; disaper{at}netverk.com.ar

Background: Invasive meningococcal infections remain an important cause of death in children. In addition, malnutrition has been classically associated with increased severity of infectious diseases. However, in our experience lethal meningococcaemia in clinically malnourished children is extremely rare. Our purpose was to determine whether there is an association between nutritional status and outcome in children with invasive meningococcal infection.

Methods: We carried out an observational study and prospectively determined anthropometrical parameters in 127 children aged 1 month to 4 years with invasive meningococcal infection seen in our inpatient facilities from August 1999 to May 2004. Severity and survival were the clinical end points analysed.

Results: Children with severe disease had higher weight for age (1.02 vs –0.19) and height for age (1.12 vs –0.58) z scores than those with non-severe disease. Non-survivors had higher weight for age (0.90 vs –0.16) and height for age (0.73 vs –0.57) z scores than survivors. Clinical and biological variables usually accepted as predictors of high mortality or severity in patients with meningococcal infection were not significantly associated with weight for age and height for age z scores.

Conclusion: In the present prospective series of children with invasive meningococcal disease, severity and death were linked to anthropometrical parameters and seemed to be associated with a very good nutritional status, which confirmed our previous uncontrolled observations.

Keywords: meningococcal infections; anthropometry; nutritional status


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