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Published online September 1, 2008
PEDIATRICS Vol. 122 No. 3 September 2008, pp. 629-632 (doi:10.1542/peds.2007-2355)
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Meningococcal Infections
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EXPERIENCE & REASON

Critical Illness and Amputation in Meningococcal Septicemia: Is Life Worth Saving?

Tom Allport, MDa, Lynley Read, PTb, Simon Nadel, MDc, Michael Levin, MDd,e

a Centre for Child and Adolescent Health, University of Bristol, Bristol, England; Departments of
b Pediatric Occupational Therapy
c Pediatric Intensive Care, St Mary's Hospital, London, England; Departments of
d Pediatrics
e International Child Health, Imperial College, London, England

ABSTRACT

Amputation is an infrequent but devastating outcome of meningococcal septicemia. We assessed daily living functions and quality of life in a cohort of children and young people, 3 to 5 years after limb amputations following severe meningococcal disease. All participants lived with their families in the community, with minimal assistance. Participants used effective strategies to compensate for motor impairment and generally had good quality of life, despite ongoing health problems (predominantly musculoskeletal). The degree of amputation did not predict the functional outcome. The surprisingly good outcomes we report should discourage clinicians from withdrawing intensive care support because of presumed poor outcomes after multiple amputations in severe meningococcal disease.

Key Words: amputation • critical care • developmental outcomes • meningococcal disease • quality of life

Abbreviations: AMPS, Assessment of Motor and Process Skills

Accepted Dec 20, 2007.


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