Critical Illness and Amputation in Meningococcal Septicemia: Is Life Worth Saving?

Author:

Allport Tom1,Read Lynley2,Nadel Simon3,Levin Michael45

Affiliation:

1. Centre for Child and Adolescent Health, University of Bristol, Bristol, England; Departments of

2. Pediatric Occupational Therapy

3. Pediatric Intensive Care, St Mary's Hospital, London, England; Departments of

4. Pediatrics

5. International Child Health, Imperial College, London, England

Abstract

Amputation is an infrequent but devastating outcome of meningococcal septicemia. We assessed daily living functions and quality of life in a cohort of children and young people, 3 to 5 years after limb amputations following severe meningococcal disease. All participants lived with their families in the community, with minimal assistance. Participants used effective strategies to compensate for motor impairment and generally had good quality of life, despite ongoing health problems (predominantly musculoskeletal). The degree of amputation did not predict the functional outcome. The surprisingly good outcomes we report should discourage clinicians from withdrawing intensive care support because of presumed poor outcomes after multiple amputations in severe meningococcal disease.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology, and Child Health

Reference12 articles.

1. Landham TL, Datta D, Nirula HC. Amputation for gangrene of the limbs following severe meningococcal infection. J R Coll Surg Edinb. 1991;36(1):11–12

2. Genoff MC, Hoffer MM, Achauer B, Formosa P. Extremity amputations in meningococcemia-induced purpura fulminans. Plast Reconstr Surg. 1992;89(5):878–881

3. Hegarty SE. Meningococcal septicaemia and the management of patients who have suffered limb loss. BAPOmag. 1999;25–28

4. Bache CE, Torode IP. Orthopaedic sequelae of meningococcal septicemia. J Pediatr Orthop. 2006;26(1):135–139

5. Lowe KG, Boyce JM. Rehabilitation of a child with meningococcal septicemia and quadrilateral limb loss: a case report. Arch Phys Med Rehabil. 2004;85(8):1354–1357

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