Of 151 patients studied with meningococcal infection, 14% had no skin lesions, 75% had generalized maculopapular or petechial lesions, and 11% had peripherally located purpuric or ecchymotic lesions. Patients with no skin lesions or those with generalized macular or petechial lesions had a greater incidence of associated meningitis but less fulminant infection. Shock and coagulation factor deficiencies and/or bleeding diathesis (DIC) were rare in these patients and mortality was low (3%). Patients with peripheral purpuric or ecchymotic skin lesions had a high incidence of fulminant infection with little or no meningeal involvement. Shock, DIC, or both were present in most and the mortality was high (44%). The presence, type, and location of skin lesions in meningococcal infection can, thus, be used as an immediate indicator of prognosis.
Toews WH, Bass JW. Skin Manifestations of Meningococcal InfectionAn Immediate Indicator of Prognosis. Am J Dis Child. 1974;127(2):173–176. doi:10.1001/archpedi.1974.02110210023003
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