Fatal meningococcal disease in childhood: an autopsy study of 86 cases.

A retrospective study of the pathology in 86 consecutive autopsies of fatal meningococcal infection in children, performed at the Red Cross War Memorial Children's Hospital during the 19-year period from 1973 to 1991, was undertaken. The most prominent pathological changes found at autopsy were those of an overwhelming bacterial infection with evidence of disseminated intravascular coagulopathy in many organs of the body. The skin, adrenal glands and central nervous system were most commonly involved. Acute myocarditis occurred in 23 cases (27%) and was diagnosed almost exclusively histologically. In only one case was it diagnosed clinically. In addition, the nutritional status and the morphological expression of immune reactivity of our hospital population was better than expected.