Meningococcemia medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Medical Therapy

Meningococcemia is a medical emergency. Persons with this type of infection are often admitted to the intensive care unit of the hospital, where they are closely monitored. The person may be placed in respiratory isolation for the first 24 hours to help prevent the spread of the infection to others. Treatments may include:

• Antibiotics given through a vein (IV), given immediately
• Breathing support
• Clotting factors or platelet replacement -- if bleeding disorders develop
• Fluids through a vein (IV)
• Medications to treat low blood pressure
• Wound care for areas of skin with blood clots

Pharmacotherapy

Acute Pharmacotherapies

• Cephalosporin CSF penetration: cefuroxime 11-14 %; ceftriaxone 1.5-7%, cefotaxime 4-54%, and ceftazidime 14%.
• Ceftriaxone CSF half life approximately 5 hours.
• Potential antibiotics include cephalosporins, penicillin, and chloramphenicol.
• Therapy may be as brief as 10 to 14 days in fully sensitive organisms.
• Steroid use particularly in purpura fulminans and adrenal hemorrhage (Waterhouse-Friderichsen syndrome) is controversial.
• Before antibiotics the case fatality rate was over 50%, particularly dangerous in infants and elderly (84% and 72% respectively). Now it is often as low as 8% in major medical centers.