Late skeletal deformities following meningococcal sepsis and disseminated intravascular coagulation.

Late skeletal deformities following meningococcemia associated with disseminated intravascular coagulation are rare. Two basic lesions have been described: epiphyseal avascular necrosis and epiphyseal-metaphyseal defects. These occur primarily in the lower extremities and result in angular deformity and leg length inequality. We recently encountered these lesions in a child 3 years following sepsis. The etiology appears to be acute vascular thrombosis of epiphyseal and metaphyseal vessels mediated through the generalized Shwartzman reaction. An increased incidence of these deformities may be anticipated as more children survive fulminant meningococcemia.