Features and outcome in meningococcal disease presenting with maculopapular rash

Article Abstract:

Meningococcal disease is the infection of the meninges, the membranes of the brain and spinal cord, with meningococci bacteria. This disease can be complicated by a hemorrhagic (purpuric) rash with lesions that are known as petechiae; they are purplish in color and may vary in size and distribution. However, meningococcal disease may sometimes be associated with a maculopapular rash, which consists of both pimple-like lesions and discolored patches. The clinical and laboratory features and prognosis of children with meningitis and maculopapular rashes were assessed and compared with those of children with meningitis and other types of rashes. Among 69 children with meningococcal disease, 26 had a maculopapular rash; 9 had only a maculopapular-type rash. Seventeen had a mixture of maculopapular and hemorrhagic rashes, including 12 children with less than 12 petechiae. When compared with the children who had only a purpuric rash, those with maculopapular rashes had greater numbers of platelets, cells involved in blood clotting; increased activity of complement, a series of proteins that can destroy bacteria and other cells when activated; and lower scores on tests evaluating the prognosis of meningococcal infection of the blood. However, the rates of death, numbers of white blood cells, and levels of C reactive protein (an abnormal protein present in certain diseases) were similar in both groups. These findings show that although meningococcal disease may be associated with only the development of a maculopapular rash, this rash does not indicate decreased disease severity. (Consumer Summary produced by Reliance Medical Information, Inc.)

Infection, Statistics, Prognosis, Meningitis, Skin, Dermatitis, Cutaneous manifestations of general diseases, Skin manifestations, Meninges, Rash (Dermatology), Rash

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Rh haemolytic disease: continuing problem of management

Article Abstract:

The Rh factor, originally described in Rhesus monkeys (hence the name Rh), is a substance that either is or is not present on the surface of red blood cells; this led to the designation for blood type of Rh-positive or Rh-negative. Rh hemolytic disease occurs when Rh-positive blood is transfused to an Rh-negative recipient or when an Rh-negative woman bears an Rh-positive fetus. The occurrence of Rh hemolytic disease during pregnancy is unusual today because of effective anti-D therapy, but sometimes anti-D therapy is not given (for example, if the Rh incompatibility is not detected). The severity of the disease may be predicted based on previous experience and results of changes in the amniotic fluid, appearance of an ultrasound scan, red blood cell volume of the first fetal blood sample, and the number of required transfusions. From 1986 to 1988, 18 women with fetuses affected by severe Rh hemolytic disease were examined; all were treated with fetal blood sampling and intrauterine transfusion. Twelve babies survived, but there were three intrauterine deaths, one stillbirth and two deaths from severe prematurity. It is well established that Rh disease becomes increasingly severe with the next pregnancy. Rh hemolytic disease follows an unpredictable course and when a case is suspected, specialists should be consulted. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Patient outcomes, Mortality, Causes of, Rh factor, Erythroblastosis fetalis, Rho(D) immune globulin

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