Skin Manifestations of Meningococcal Infection

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.