Prognosis

The overall mortality rate of meningococcal infections is 10% to 15%.[26]​​

Patients with meningitis have a lower mortality rate (5%) than those with meningococcal sepsis (5% to 40%). Most deaths due to meningococcal meningitis occur in the first 24 hours of illness.[85]​ Mortality rates are higher in adolescents than in younger children, and higher during outbreaks than in sporadic disease.[86][85]

Clinical and demographic risk factors for adverse outcomes include age (infants, young adults and those >60 years of age), association with an outbreak, coma, hypotension, a rapidly progressive rash, absence of nuchal rigidity, focal neurological signs, leukopenia/neutropenia, acidosis, thrombocytopenia, coagulopathy, and low serum C-reactive protein concentration.

Between 10% and 20% of survivors of meningococcal meningitis have permanent neurological sequelae, including sensorineural hearing loss, seizure disorders, blindness, motor disorders, and intellectual impairment.[26]​ Around 20% to 30% of children have more subtle adverse outcomes such as academic and behavioural problems.[87][88][89][90]

Thrombosis and tissue oedema may result in skin necrosis, compartment syndrome, or other ischaemic injury to extremities, and require skin grafts or amputation of digits or extremities.

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