Management and clinical outcomes of meningococcal disease in pediatric and adolescent patients in Makkah, Saudi Arabia: A retrospective bicenter study.

OBJECTIVES: The study aimed to determine the incidence and characteristics of meningococcal disease in pediatric patients admitted to Maternity and Children Hospital and Al-Noor Specialist Hospital in Makkah from August 2016 to August 2024. METHODS: This bicenter retrospective cohort study included pediatric patients (≤ 18 years) with culture-confirmed Neisseria meningitidis infection identified through hospital electronic records using International Classification of Diseases codes. Due to limited case numbers, descriptive analysis was used to explore incidence, serogroup distribution, treatment outcomes, and correlations with patient characteristics. RESULTS: Two cases were identified. Case 1 was a 22-day-old Saudi infant with N meningitidis conjunctivitis during Ramadan (Umrah season) showing localized infection. Case 2 was a 12-year-old Egyptian girl with classical meningococcal meningitis acquired during Hajj 1445 AH. Neither patient had long-term complications or travel to the African meningitis belt; only Case 2 had a clear Hajj exposure.Both cases were successfully managed and discharged without complications. CONCLUSION: Although rare, meningococcal infections continue to emerge during mass gatherings like Hajj and Umrah, with varying clinical presentations. These cases demonstrate the broad spectrum of meningococcal disease (from localized conjunctivitis to invasive meningitis) and underline the need for continuous surveillance, stricter vaccination enforcement, and awareness of nontraditional presentations.