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Table 1 Comparison between meningococcal (n = 195) and pneumococcal (n = 67) purpura fulminans

From: Clinical phenotype and outcomes of pneumococcal versus meningococcal purpura fulminans: a multicenter retrospective cohort study

  Meningococcal purpura fulminans n = 195 Pneumococcal purpura fulminans n = 67 p value
Patient’s characteristics and ICU scores
Male gender 97 (50) 37 (55) 0.527
Age, years 24 [19–45] 49 [38–60]  < 0.001
SAPS II 50 [35–66] 63 [58–72]  < 0.001
SOFA 11 [8–14] 14 [11–15]  < 0.001
Main comorbidities
Chronic alcoholism 5 (2) 9 (13) 0.002
Diabetes mellitus 3 (2) 4 (6) 0.073
Asplenia or hyposplenia 3 (2) 34 (51)  < 0.001
Malignant hemopathy 1 (1) 2 (3) 0.162
Chronic respiratory disease 18 (23) 14 (28) 0.625
Immunocompromised status 5 (3) 4 (6) 0.241
No coexisting comorbid conditions 164 (84) 22 (33)  < 0.001
Clinical features upon ICU admission
Days between disease onset and ICU admission, days 4 [4–5] 5 [4–6] 0.003
Headache 99 (51) 26 (39) 0.121
Myalgia 48 (25) 12 (18) 0.338
Digestive signs 124 (64) 41 (61) 0.839
Coma Glasgow score 15 [13–15] 15 [13–15] 0.751
Temperature, °C 38.5 [37–40] 38.5 [37–39] 0.802
Neck stiffness 52 (27) 6 (9) 0.004
Purpuric rash before ICU admission 168 (86) 38 (57)  < 0.001
β-Lactam antibiotic therapy before ICU admission 157 (81) 46 (69) 0.067
β-Lactam antibiotic therapy at ICU admission 195 (100) 67 (100)
Biological data upon ICU admission
Leukocytes count, 103 mm−3 10,700 [4000–20,800] 10,655 [2500–19,750] 0.717
Platelets count, 103 mm−3 61,000 [28,500–100,000] 33,000 [19,000–49,500]  < 0.001
C-reactive protein, g/L 148 [90–247] 179 [141–289] 0.095
Procalcitonin, ng/mL 48 [14–100] 102 [55–164] 0.087
Troponin, mg/L 1 [0.10–12] 0.25 [0.13–11] 0.697
Creatine kinase, IU/L 300 [110–852] 812 [365–3460] 0.016
Serum urea, mmol/L 9 [7–11] 13 [11–15]  < 0.001
Serum creatinine, μmoL/L 190 [136–250] 240 [184–310]  < 0.001
Prothrombin time, % 33 [22–44] 29 [15–38] 0.227
Factor V, % 23 [10–49] 21 [9–29] 0.246
Arterial lactate, mmol/L 7.40 [5–11] 8 [6–11] 0.798
Fibrinogen, g/L 1.70 [0.6–3] 1.16 [0.5–2] 0.122
Microbiological data at ICU admission
Bacteremia 99 (51) 56 (84  < 0.001
Lumbar puncture performed 125 (64) 29 (43) 0.004
Positive cerebro-spinal fluid culture 72/125 (58) 11/29 (38) 0.080
Outcome in the ICU
Lowest LVEF, % 33 [20–45] 30 [25–50] 0.870
Inotropic agent 91 (64) 35 (61) 0.894
Platelets transfusion 57 (29) 46 (69)  < 0.001
Plasma transfusion 67 (34) 44 (66)  < 0.001
Steroids for septic shock or meningitis 116 (60) 45 (67) 0.333
Activated protein C 33 (17) 9 (13) 0.632
Invasive mechanical ventilation 152 (78) 65 (97) 0.001
Duration of tracheal intubation, days 4 [2–9] 10 [3–28]  < 0.001
Duration of vasopressors, days 3 [2–5] 5 [3–8]  < 0.001
Renal replacement therapy 69 (36) 45 (67)  < 0.001
Veno-arterial ECMO 7 (4) 6 (9) 0.104
Limb amputation 19 (10) 21 (31)  < 0.001
Limb amputation among ICU survivors 18/125 (14) 19/32 (59)  < 0.001
Death in ICU 70 (36) 35 (52) 0.027
Duration of ICU stay, days 5 [2–11] 14 [3–35]  < 0.001
Duration of hospital stay, days 12 [2–23] 23 [3–78] 0.003
  1. Continuous variables are reported as median [Interquartile range] and compared between groups using the Student t-test. Categorical variables are reported as numbers (percentages) and compared using χ2 test. A p value < 0.05 was considered significant
  2. ICU intensive care unit; IMV Invasive Mechanical Ventilation, ECMO Extracorporeal membrane oxygenation, LVEF Left ventricular ejection fraction, SAPSII Simplified Acute Physiology Score, SOFA Sequential Organ Failure Assessment