FATAL INTRAVASCULAR CONSUMPTION COAGULOPATHY IN MENINGOCOCCAL SEPSIS

Five patients with meningococcal sepsis who died with a rapidly progressing hemorrhagic diathesis secondary to intravascular consumption coagulopathy (IVCC) associated with irreversible shock are discussed in detail. Review of the microscopic pathology showed gram-negative diplococci within necrotic dermal endothelial cells, extensive necrosis of vascular endothelium without bacterial invasion in extradermal sites and free floating intraluminal fibrin-leukocyte-platelet clots. It is postulated that the meningococcal organism and especially the endotoxin it produces initiates accelerated intravascular clotting primarily by injurying the vascular endothelium. It is suggested that IVCC may be a frequent occurrence in meningococcemia and should be looked for in all patients with this infection since early diagnosis and initiation of proper therapy may prevent death secondary to fulminating hemorrhage and irreversible shock. © 1969.