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

Shravani Bobde; Woo-Yun Sohn; Rafik Bekkat-Berkani; Angelika Banzhoff; Athena Cavounidis; Ener Cagri Dinleyici; Wilfrido Coronell Rodriguez; Nelly Ninis

doi:10.1007/s40121-023-00906-x

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

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

Authors

Shravani Bobde¹, Woo-Yun Sohn², Rafik Bekkat-Berkani², Angelika Banzhoff³, Athena Cavounidis⁴, Ener Cagri Dinleyici⁵, Wilfrido Coronell Rodriguez^{6

7}, Nelly Ninis⁸

Affiliations

¹ GSK, 14200 Shady Grove Rd, Rockville, MD, 20850, USA. shravani.s.bobde@gsk.com.
² GSK, 14200 Shady Grove Rd, Rockville, MD, 20850, USA.
³ GSK, Marburg, Germany.
⁴ GSK, Wavre, Belgium.
⁵ Department of Pediatrics, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey.
⁶ Pediatric Infectious Diseases, University of Cartagena, Cartagena, Colombia.
⁷ Serena del Mar Hospital, Cartagena, Colombia.
⁸ Imperial College Healthcare NHS Trust, London, UK.

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.

Publication types

Review