Hemodynamic and Neurological Presentations of Invasive Meningococcal Disease in Adults

link.springer.com September 15, 2025

Neurological and hemodynamic presentation of invasive meningococcal disease (IMD) are clinically and prognostically distinct. Recognition of these phenotypes is critical for appropriate management and prediction of outcome.

Of 654 patients (median age 33 years [IQR 21–56]; 63.5% without comorbidities), 407 (62%) had a neurological and 247 (38%) a hemodynamic presentation at ICU admission.

Hemodynamic presentation was associated with older age (39.0 vs. 30.0 years; p = 0.001), immunosuppression (17.0% vs. 7.1%; p < 0.001), purpuric rash (55.9% vs. 43.7%; p = 0.003), earlier ICU admission (1 vs. 2 days; p = 0.001) and more frequent bacteremia (83.8% vs. 35.6%; p < 0.001). Serogroup B was predominant in neurological presentation, whereas serogroup W135 was more common in hemodynamic presentation.