Surgical issues of the treatment of meningococcal disease in children

Budkevich L.I.; Mirzoyan G.V.; Soshkina V.V.

doi:https://doi.org/10.17116/hirurgia2025091104

Budkevich L.I.

Veltischev Research Clinical Institute of Pediatrics and Pediatric Surgery of the Pirogov Russian National Research Medical University;
Children’s City Clinical Hospital No. 9, named after G.N. Speransky

ORCID: 0000-0002-8975-6108

Mirzoyan G.V.

Children’s City Clinical Hospital No. 9, named after G.N. Speransky

ORCID: 0009-0005-2229-215X

Soshkina V.V.

Children’s City Clinical Hospital No. 9, named after G.N. Speransky

ORCID: 0000-0002-8605-8670

Surgical issues of the treatment of meningococcal disease in children

Authors:

Budkevich L.I., Mirzoyan G.V., Soshkina V.V.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2025;(9): 104‑114

DOI: 10.17116/hirurgia2025091104

Read: 438 times

Contact the author

Table of contents

To cite this article:

Budkevich LI, Mirzoyan GV, Soshkina VV. Surgical issues of the treatment of meningococcal disease in children. Pirogov Russian Journal of Surgery. 2025;(9):104‑114. (In Russ.)
https://doi.org/10.17116/hirurgia2025091104

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)

Использование инфографики авторами научных работ

BACKGROUND

The paper addresses an important section of pediatric combustiology — generalized meningococcal infection, associated with a severe course, the risk of disabling complications, life-threatening conditions, and high mortality.

OBJECTIVE

The purpose of the study was to share the experience of treating patients with the sequelae of generalized bacterial infection caused by Neisseria meningitidis in a children’s burn center.

MATERIAL AND METHODS

We conducted a retrospective analysis of the medical records of 23 patients treated in the burn department for babies from 0 to 3 years of the Children’s City Clinical Hospital No. 9, named after G.N. Speransky, in the period between 2008 and 2025 for the surgical sequelae of meningococcal disease.

Clinical cases illustrate the late diagnosis of meningococcal infection, the challenges of treating septic shock in the intensive care unit, surgical methods for repairing damaged skin and underlying tissues resulting from generalized meningococcal infection, as well as the indications and timing of organ-resecting surgery. The issues of prevention of this disease in children are considered.

RESULTS

Summarizing treatment outcomes is a challenging task due to the individualized approach to providing specialized medical care during surgical interventions, which varies depending on the severity of each patient’s condition, as well as the depth and extent of tissue involvement.

CONCLUSION

Based on the above, managing such patients requires continuity in treatment following a widely used, unified protocol for local pediatricians, ambulance teams, infectious disease doctors, intensivists, pediatric surgeons, traumatologists, and medical rehabilitation specialists.

Keywords:

meningococcal infection

wounds

tangential debridement

autodermoplasty

hydrosurgical treatment of wounds

free split graft

amputation

children

Authors:

Budkevich L.I.

ORCID: 0000-0002-8975-6108

Mirzoyan G.V.

Children’s City Clinical Hospital No. 9, named after G.N. Speransky

ORCID: 0009-0005-2229-215X

Soshkina V.V.

Children’s City Clinical Hospital No. 9, named after G.N. Speransky

ORCID: 0000-0002-8605-8670

Received:

10.06.2025

Accepted:

28.07.2025

Close metadata

References:

Meningococcal infection. Edited by N.D. Yushchuk and Yu.Ya. Vengerov. M.: GEOTAR-Media, 2019. (In Russ.).
Haperin SA, Bettinger JA, Greenwood B, et al. Thechanging and dynamic epidemiology of meningococcal disease. Vaccine. 2012;30(2):826-836. https://doi.org/10.1016J.vaccine.2011.12.032.
Clinical guidelines. Meningococcal infection in adults. Meningococcemia. Moscow, 2015. (In Russ.).
Brandtzaeg P. Pathogenesis and pathophysiology of invasive meningococcal disease. In: Frosch M, Maiden M, eds. Handbook of Meningococcal Disease. Weinheim: Wiley-VGH-Verlag, 2006. https://doi.org/10.1002/3527608508.ch21
Zhdanov KV, Kovalenko AN, Chirsky VS, et al. Clinical and Pathomorphological Characteristics of Meningococcal Infection with Fatal Outcome in Young Adults. Military Medical Journal. 2020;341(12):35-40. (In Russ.).
Thompson MJ, Ninis N, Perera R, et al. Clinical recognition of meningococcal disease in children and adolescents. Lancet. 2006;367:397-403. https://doi.org/10.1016/S0140-6736(06)67932-4
Van der Poll T, Wiersinga WJ. Sepsis and Septic Shock. In: Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 9th edit. Philadelphia: Elsevier, 2019.
Solovieva T.S. Morphological aspects of fulminate meningococcemia. Bulletin of the Russian Military Medical Academy. 2018;2:179
Jahangir-Hekmat M, Taylor HC, Levin H, et al. Adrenal insufficiency attributable to adrenal hemorrhage: long-term follow-up with reference to glucocorticoid and mineralocorticoid function and replacement. Endocr Pract. 2004;10(1):55-61.
Friedl C, Hackl G, Schilcher G, et al. Waterhouse-Friderichsen syndrome due to Neisseria meningitidis infection in a young adult with thrombotic microangiopathy and eculizumab treatment: case report and review of management. Ann Hematol. 2017;96(5):879-880.
Pode-Shakked B, Sadeh-Vered T, Kidron D, et al.Waterhouse Friderichsen syndrome complicating fulminant Enterobacter cloacae sepsis in a preterm infant: the unresolved issue of corticosteroids. Fetal Pediatr Pathol. 2014;33(2):104-108.
Zessis NR, Nicholas JL, Stone SI. Severe bilateral adrenal hemorrhages in a newborn complicated by persistent adrenal insufficiency. Endocrinol Diabetes Metab Case Rep. 2018;2018.pii:17-0165.
de Greeff SC, de Melker HE, Schouls LM, et al. Pre-admission clinical course of meningococcal disease and opportunities for the earlier start of appropriate intervention: a prospective epidemiological study on 752 patients in the Netherlands, 2003—2005. Eur J Clin Microbiol Infect Dis. 2008;27(10):985-992. https://doi.org/10.1007/s10096-008-0535-1
Tormos LM, Schandl CA. The significance of adrenal hemorrhage: undiagnosed Waterhouse-Friderichsen syndrome, a case series. J Forensic Sci. 2013;58(4):1071-1074.
Russcher A, Fanoy E, Van Olden GDJ, et al. Necrotising fasciitis as atypical presentation of infection with emerging Neisseria meningitidis serogroup W clonal complex 11, the Netherlands, March 2017. Euro Surveill. 2017;22:30549.
Koroleva IS, Koroleva MA, Beloshitsky GV. The current epidemic situation of meningococcal infection in the Russian Federation and the possibility of prevention. Epidemiology and Hygiene. 2016;15-17. (In Russ.).