Clinical manifestations and course of meningococcal disease in 562 patients.

To describe the clinical manifestations and course of meningococcal disease (MD) data were collected on patients with culture-proven MD, reported in the Netherlands between April 1, 1989 and April 30, 1990 by means of a questionnaire completed by the specialist in attendance. During the study period, 562 patients (295 males, 267 females) were reported. The age of the patients ranged from 2 weeks to 88 years. Of the patients, 57.8% were classified as meningitic, 20.3% as bacteraemic and 21.9% as both meningitic and bacteraemic. In 4.6% of the patients a predisposing factor was present, and in 1.4% a previous episode of meningitis had occurred. A positive family history of meningitis was reported in 12.9% of the patients. On admission, 65.2% of the patients had haemorrhagic skin lesions, 7.9% coma and 4.2% seizures. During admission, 17.8% of the patients developed serious complications. The fatality rate was 7.7%. In 73.2% of the deceased, death occurred within 2 days after admission. Of the survivors, 8.5% recovered with serious sequelae. In conclusion, 16% of the patients with meningococcal disease either died or became severely disabled. Prevention of this putative life-threatening disease seems to be the only means of circumventing the problems caused by this serious condition.