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