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Review
. 2024 Feb;13(2):251-271.
doi: 10.1007/s40121-023-00906-x. Epub 2024 Jan 29.

The Diverse Spectrum of Invasive Meningococcal Disease in Pediatric and Adolescent Patients: Narrative Review of Cases and Case Series

Shravani Bobde  1 , Woo-Yun Sohn  2 , Rafik Bekkat-Berkani  2 , Angelika Banzhoff  3 , Athena Cavounidis  4 , Ener Cagri Dinleyici  5 , Wilfrido Coronell Rodriguez  6   7 , Nelly Ninis  8
Affiliations
Review

The Diverse Spectrum of Invasive Meningococcal Disease in Pediatric and Adolescent Patients: Narrative Review of Cases and Case Series

Shravani Bobde et al. Infect Dis Ther. 2024 Feb.

Abstract

Introduction: Invasive meningococcal disease (IMD) is a potentially life-threatening disease caused by Neisseria meningitidis infection. We reviewed case reports of IMD from newborns, infants, children, and adolescents, and described the real-life clinical presentations, diagnoses, treatment paradigms, and clinical outcomes.

Methods: PubMed and Embase were searched for IMD case reports on patients aged ≤ 19 years published from January 2011 to March 2023 (search terms "Neisseria meningitidis" or "invasive meningococcal disease", and "infant", "children", "paediatric", pediatric", or "adolescent").

Results: We identified 97 publications reporting 184 cases of IMD, including 25 cases with a fatal outcome. Most cases were in adolescents aged 13-19 years (34.2%), followed by children aged 1-5 years (27.6%), children aged 6-12 years (17.1%), infants aged 1-12 months (17.1%), and neonates (3.9%). The most common disease-causing serogroups were W (40.2%), B (31.7%), and C (10.4%). Serogroup W was the most common serogroup in adolescents (17.2%), and serogroup B was the most common in the other age groups, including children aged 1-5 years (11.5%). The most common clinical presentations were meningitis (46.6%) and sepsis (36.8%).

Conclusions: IMD continues to pose a threat to the health of children and adolescents. While this review was limited to case reports and is not reflective of global epidemiology, adolescents represented the largest group with IMD. Additionally, nearly half of the patients who died were adolescents, emphasizing the importance of monitoring and vaccination in this age group. Different infecting serogroups were predominant in different age groups, highlighting the usefulness of multivalent vaccines to provide the broadest possible protection against IMD. Overall, this review provides useful insights into real-life clinical presentations, treatment paradigms, diagnoses, and clinical outcomes to help clinicians diagnose, treat, and, ultimately, protect patients from this devastating disease.

Keywords: Adolescents; Case reports; Children; Complications; Meningococcal disease; Pediatrics.

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Conflict of interest statement

Shravani Bobde, Woo-Yun Sohn, Rafik Bekkat-Berkani, and Athena Cavounidis are employees of GSK and may hold stock or stock options. Shravani Bobde holds patents on antimicrobial peptides and related methods issued prior to employment at GSK and before this work began. Angelika Banzhoff was an employee of GSK, holding stock or stock options when this study was undertaken. Ener Cagri Dinleyici performs contract work for the Eskisehir Osmangazi University funded by GSK, Pfizer, and Sanofi Pasteur. Wilfrido Coronell Rodriguez has received honoraria from Merck Sharp & Dohme and Sanofi Pasteur, and has participated on advisory boards at GSK, Pfizer, and Sanofi Pasteur. Nelly Ninis has received payment and/or honoraria from GSK.

Figures

Fig. 1
Fig. 1
Study flowchart. aSearch terms (“Neisseria meningitidis”, “invasive meningococcal disease”) and (“infant”, “children”, “paediatric”, “pediatric”, or “adolescent”) and (“case report” and “case series”). IMD invasive meningococcal disease
Fig. 2
Fig. 2
Clinical presentations in 133 IMD cases. Multiple clinical presentations may be reported for each patient. The data represent the total number of occurrences of each clinical presentation, with each patient potentially included in multiple sections of the pie chart. IMD invasive meningococcal disease
See this image and copyright information in PMC

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