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Introduction: Despite the success in the development of medicines and vaccines, meningococcal disease (MD) remains a relevant public health problem due to its global distribution, epidemic potential and high lethality, which has remained around 20%. The Emilio Ribas Institute of Infectious Diseases (IIER) is an exclusive tertiary hospital for infectious diseases, a reference center for meningitis and other pathologies, in the State of São Paulo, Brazil and has its prominent role in the history of meningococcal disease. Children with MD may have sequelae that impact long-term quality of life; hearing loss, motor and cognitive impairment, seizures and behavioral alterations are described in the literature, but the data are few and limited, especially in the pediatric population. Objectives: 1- to identify the number of cases of MD admitted to the IIER,
in the pediatric age group (under 18 years of age incomplete), from 2012 to 2018; 2- to characterize, with clinical and laboratory analysis, the cases of MD identified in the period; 3 – to identify the sequelae of DM in the pediatric population of the study; 4 – to define the dm lethality rate, in the period, in the IIER; 5 – to determine the distribution of meningococcal serogroups of DM cases in the studied period. Methods: retrospective, non-interventional study, with data obtained through analysis of medical records and laboratory database of patients under 18 years of age who were admitted to the IIER with a diagnosis of confirmed MD, in the period from 2012 to 2018. Results: 60 patients from 0 to 17 years were included in the studies with MD, 46/60 presented confirmation by specific laboratory criterion (PCR, latex and/or culture), 5/60 presented confirmation by nonspecific laboratory criterion (gram diplococode in bacterioscopy), 8/60 by clinical criterion and 1/60 by epidemiological link. The median age of the patients included in the study was 11 years, with 70% of patients between 5 and 14 years of age. Only 15% of patients could have received the conjugated meningococcal C vaccine (MCC) by the Brazilian PNI before the DM episode. The most common meningococcal serogroup was C (63,3%), followed by B (6,7%) and the main diagnostic confirmation method was by chain polymerase (PCR) reaction in cerebrospinal fluid (CSF). Thirty-five percent of patients developed inflammatory symptoms (arthritis, uveitis/endophthalmitis, pericardial effusion, myocarditis, erythema nodosum, appendicitis, pancreatitis, gastritis, esophagitis, duodenitis) and 27% had oral herpes during treatment. Twelve patients (20.7%) recovered with at least one sequel (main: 8.6% hearing loss and 8.6% musculoskeletal sequelae).Conclusion: the predominant serogroup of the study was C, possibly due to the predominant age group in the study and which had not yet been contemplated with the MCC vaccine. The percentage of inflammatory symptoms associated with the condition was higher than that reported in the literature for the pediatric age group. Patients with MD are not routinely followed up after discharge for screening and followup of sequelae, despite the high rate of sequelae found in this study and in other studies in the literature that covered this theme.
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