Clinical criteria:
(1) child aged 3 months to 10 years (is the onset after 3 months evidence of protective maternal antibodies?)
(2) fever >= 38.5°C
(3) presence of abdominal pain and/or vomiting
(4) onset of petechiae and/or purpura <= 72 hours after onset of the fever
(5) history of purulent conjunctivitis <= 15 days before the onset of the fever
(6) CSF leukocyte count <= 100 leukocytes per µL
(7) pathologic findings of purpura fulminans (diffuse hemorrhage, hemorrhage into the adrenal glands, microthrombi consistent with DIC)
Exclusions:
(1) no evidence of meningitis with negative viral, bacterial and fungal cultures
(2) negative tests for Neisseria meningitides
(3) negative blood cultures
Haemophilus influenzae var aegyptius was found to be the cause of the purulent conjunctivitis. In theory the organism could be isolated during the fulminant disease.
