Detailed Information on Meningococcemia

                                                                                         

Meningococcemia is an acute disease of the bloodstream and developing vasculitis (inflammation of the blood vessels). Meningococcemia is caused by bacteria called Neisseria meningitidis. N meningitidis infection can be clinically polymorphic. The most common illness presentation is meningitis. The bacteria often live in a person's upper respiratory tract without causing visible signs of illness. Some event is thought to cause the onset of aggressive behavior of the bacteria, and sporadic cases of meningococcemia and meningococcal meningitis appear. Family members and those closely exposed to an infected individual are at increased risk.

The infection occurs more frequently in winter and early spring. Meningococcemia, a relatively uncommon infection, occurs most commonly in children and young adults. Children younger than 4 years have the highest risk of developing meningococcal disease. As the child grows older, asymptomatic exposure to a variety of encapsulated and no encapsulated N meningitidis strains increases protective bacterial immunity. Symptoms can develop within one day to one to two weeks. After a short period of time (one hour up to one to two days) when the patient complains of fever and muscle aches, more severe symptoms can develop.

Other symptoms of Meningococcemia involve anxiety, fever, irritability and spotty red or purple rash (petechiae). The most important measure in treating meningococcemia is early detection and fast administration of antibiotics. Medications include intravenous (IV) antibiotics to eliminate the infection, and high doses of corticosteroids for shock (must be given early). Penicillin G is the antibiotic of choice for susceptible isolates. This treatment will decrease the risk of infection in these people who have been exposed. Clotting factors or platelet replacement may be needed if bleeding disorders develop.

Severe supportive care is required for patients with fulminant meningococcemia. Central venous access facilitates the administration of massive amounts of volume expanders and inotropic medications needed for adequate tissue perfusion. Pericardiocentesis may be necessary if pericarditis is complicated by tamponade. Prevention is better than cure. The employ of artificial skin can spare the patient immediate use of autograft sites, which frequently are limited. Avoid amputation whenever useful function of a limb can be salvaged. Poor tissue perfusion may also lead to dental complications that require extensive extraction of severely affected teeth.

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