INTRAFAMILIAL CLUSTER OF MENINGOCOCCAL PURPURA FULMINANS: THREE FATAL CASES IN MOROCCO

Meningococcal purpura fulminans is the most severe manifestation of invasive Neisseria meningitidis, characterized by septic shock, disseminated intravascular coagulation (DIC), and extensive necrotic skin lesions. Despite aggressive modern intensive care, its rapid progression often renders treatment ineffective. We describe three consecutive cases involving previously healthy women (ages 39, 41, and 46) admitted to the Moulay Abdellah Hospital in Sale. All patients presented with acute infectious syndromes and rapidly spreading purpura. Despite immediate management - including meningeal-dose ceftriaxone, corticosteroids, and vasopressor support - the clinical course was fulminant, with mortality occurring between 30 minutes and 12 hours post-admission. Notably, two patients were sisters, suggesting intrafamilial transmission. Diagnosis was confirmed via multiplex PCR in one case,while the extreme speed of death precluded microbiological confirmation in the others. These cases underscore the devastating virulence of N. meningitidis and the critical limitations of reactive therapy. The findings emphasize that survival depends on hyper-early recognition and immediate empirical antibiotic administration. Furthermore, this cluster highlights the vital role of preventive strategies, specifically vaccination and urgent chemoprophylaxis for close contacts, to manage transmission risks and reduce mortality in high-risk environments.