An attempt at an epidemiological explanation - Epib.nl

Chapter 1is assumed to be the main trigger of septic shock and diffuse intravascular coagulation.17oAfter entering the bloodstream of the host, the meningococcus may cause a varietyof clinical syndromes ranging from a benign flu-like disease ("chronic meningococcemia")to fuhninant septicemia with septic shock and multiple organ failure,l2« 53 71 72 The most common clinical manifestation of MD, however, is meningitis,but in 8-18% of the cases septicemia is the sole manifestation.'''''''87'.'' In septicemiasevere bemodynamic disturbances and coagulopathy (diffuse intravascularcoagulation) may occur, characterized by pronounced shock, renal insufficiency,cardiac failure, adult respiratory distress syndrome, and massive bleeding in manyorgans, such as the adrenal glands, gastrointestinal tract and cerebrum.' 72Case-fatality rate and sequelaeThe crude case-fatality rate (CFR) of MD ranges from 2_14%.'728364' SO·S) 57·59 06 73·76Fatalities may be directly due to cerebral damage (cerebral infarcts and herniationdue to brain edema), but result more often from pronounced endotoxic shock. 131ODepending on the definitions and circumstances the reported CFRs among meningiticpatients range from 1-11%, whereas those among septicemic patients range from 9-41 %.36 .450 "" 58 067