THE CUTANEOUS LESIONS IN ACUTE MENINGOCOCCEMIA

Abstract

The presence of a cutaneous rash has always been recognized as one of the earliest and most reliable clinical signs in meningococcemia, a fact that has led clinicians in the past to employ such titles as malignant purpuric fever, petechial fever, black fever and spotted fever for these infections. The purpose of this paper is to discuss the cutaneous manifestations of meningococcic infection and to comment on their pathogenesis in relation to the histologic observations in specimens of skin of persons who have had meningococcemia. This study is based on 25 cases taken from the autopsy files of the Peter Bent Brigham, Boston Children's and Boston City hospitals, in which the patients exhibited lesions of the skin during the course of the disease and died as the result of acute meningococcic infection. HISTORY The first epidemic of meningococcemia reported in North America occurred in Medfield, Mass.¹ in 1806. eighty-one