MENINGOCOCCAL MENINGITIS IN PEDIATRIC PATIENTS: THE IMPORTANCE OF DIFFERENTIAL DIAGNOSIS AND GOOD MULTIPROFESSIONAL CARE

Abstract

Meningococcemia is the invasive form of meningococcal infection. Objective: To conduct a case study showing the importance of rapid differential diagnosis in cases of meningococcal meningitis in a pediatric patient. Methodology: retrospective, descriptive study of secondary data from the electronic medical record. Case study: 15-year-old male with a diagnosis of bacterial meningitis, complaining of fever, ecchymatous lesions on the upper limb associated with edema, drowsiness, nausea, myalgia and a history of hematemesis. The patient had consumed alcohol during New Year's Eve dinner, and his mother thought this was the reason for the symptoms. During the first consultation at the SPA, upon receiving the empirical diagnosis of meningococcemia, antibiotic treatment was immediately started. He did not present meningeal rigidity. He was lucid and able to make contact but had cyanosis of the extremities (feet and hands). A lumbar puncture was performed, which revealed whitish, cloudy cerebrospinal fluid (CSF). Meningococcal disease was evidenced with a CSF result of 500 cells, presenting N. Meningitis. The patient had episodes of nystagmus (involuntary eye movements). After 16 days in the pediatric ICU, he was still unable to walk. Hemodynamically stable, on room air, eupneic, able to contact, and collaborative. The patient was discharged to the ward for clinical follow-up. Conclusion: it is necessary to have professionals who use their knowledge to apply a multifocal approach to reach a differential diagnosis and thus begin treatment as early as possible and avoid sequelae.