Oakley J R, Stanton A N
Br Med J. 1979 Aug 25;2(6188):468-9. doi: 10.1136/bmj.2.6188.468.
The first 10 deaths from meningococcal infections in children aged under 2 years that were reported to a DHSS multicentre study were reviewed. Confidential inquiries were made of the parents, family doctors, health visitors, and hospital staff concerned with each case, and management was discussed with a paediatrician and pathologist. Diagnosis and treatment were often delayed because doctors did not realise the importance of the purpuric rash. One child died at home, and by the time they were admitted to hospital all the remaining nine were shocked and needed resuscitation. Prodromal symptoms, mainly changes in behaviour, preceded the rash in all cases. These prodromal symptoms should arouse the suspicion of septicaemia and prompt a search for petechiae so that early effective treatment may be started.
对向卫生和社会保障部多中心研究报告的2岁以下儿童因脑膜炎球菌感染导致的最初10例死亡病例进行了回顾。对涉及每个病例的父母、家庭医生、健康访视员和医院工作人员进行了保密询问，并与一名儿科医生和病理学家讨论了治疗情况。由于医生没有意识到紫癜皮疹的重要性，诊断和治疗常常被延误。一名儿童在家中死亡，在其余9名儿童入院时，他们都已休克，需要进行复苏。在所有病例中，前驱症状（主要是行为改变）先于皮疹出现。这些前驱症状应引起对败血症的怀疑，并促使寻找瘀点，以便尽早开始有效治疗。
