Meningococcal meningitis in children in Casablanca, Morocco. A review of 245 cases.

A retrospective study of 245 cases of meningococcal meningitis was conducte d in the pediatric infectious diseases unit of the Casablanca pediatric hos pital. Patients seen between 1980 and 1997 were studied. Abrupt onset of ty pical meningeal symptoms was noted in 80% of cases, often after an episode of nasopharyngitis. When present, neurological manifestations were mild. Pu rpura was the most common skin lesion (45.3%). Conventional bacteriological studies provided the diagnosis in 90% of cases. The meningococcus was grou p A in 53% of cases. The overwhelming majority of patients (98.4%) were giv en amoxicillin or ampicillin. Although treatment was appropriate, residual neurovisual impairment was found in 21% of reevaluated patients. Younger ag e, presence of seizures, alterations in consciousness, delay in seeking med ical advice, and low cerebrospinal fluid glucose were associated with a poo rer prognosis.