MENINGOCOCCEMIA ASSOCIATED WITH INTRAVASCULAR COAGULATION

Abstract

Changes indicating the occurrence of diffuse intravascular clotting (thrombocytopenia and depletion of fibrinogen, prothrombin, and factors V, VIII, and IX) were observed in a child with fulminant meningococcemia. Therapy with penicillin, heparin, epsilon-aminocaproic acid, and hydrocortisone resulted in rapid reversal of coagulation factor abnormalities and a favorable outcome. Determination of the incidence of intravascular clotting in meningococcemia and the influence of heparin therapy on the course of such cases requires further study. The findings of the present case suggest that (1) screening tests for intravascular clotting should be done in all cases of meningococcemia, and (2) heparin therapy may be beneficial when evidence of intravascular clotting is observed.