Meningococcemia overview
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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]
Overview
Meningococcemia is the presence of Neisseria meningitidis (also known as meningococcus), a severe bacterical infection, in the blood stream. It is demonstrated by blood culture. The disease is hard to identify as it can appear in several different forms, depending on which part of the body the bacteria invade. Neisseria meningitides is a gram-negative diplococcus. The bacteria is known to cause meningitis, septicaemia, pneumonia, and even rarely urethritis.
Most cases of meningococcal meningitis occur in children. Early recognition and treatment of anyone exposed to meningococcus is extremely important to prevent serious illness or death. In cases of serious infection, sufferers may have to have limbs amputated as infected flesh dies off and may otherwise spread gangrene.
Diagnosis
One of Four Scenarios is Often Present
- Bacteremia without sepsis. Admission for upper respiratory illness or viral exanthem. Positive blood cultures for Neisseria meningitides.
- Meningococcemia without meningitis. Septic patient with leukocytosis, skin rashes, generalized malaise, weakness, headache, and hypotension on admission or shortly after.
- Meningitis with or without meningococcemia. Patients with headache, fever, meningeal signs and cloudy spinal fluid. No pathologic reflexes.
- Meningoencephalitic presentation. Profoundly obtunded with meningeal signs and septic spinal fluid. Altered reflexes (either absent or rarely hyperactive). Pathologic reflexes are often present.