Meningococcemia - Symptoms and Treatment

Meningococcemia is the presence of meningococcus in the bloodstream. Meningococcus, a bacteria formally called Neisseria meningitidis , can be one of the most dramatic and rapidly fatal of all infectious diseases. It is demonstrated by blood culture . This disease is hard to identify as it can appear in several different forms, depending on which part of the body the bacteria invade. There can be meningitis or septicaemia , or a combination of both.

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. Meningococci can live in the pharynx of some people (healthy carriers) without producing any kind of symptoms. These people are sufficiently immune or have sufficient defenses to protect them from the disease. However, carriers do expel meningococci and therefore play a very important role in the transmission of the illness, since meningococci can make contact with a healthy person and, instead of producing another carrier, cause illness. The microorganism is transmitted from person to person through the pharyngeal and nasal secretions, and requires close contact for infection (sleeping in the same room, sharing a house, kissing). Meningococci does not live long outside the body and therefore infection is not produced by contact with toys or other school utensils.

Causes of Meningococcemia

Find common causes and risk factors of Meningococcemia:

• Individuals with complement component deficiencies have an increased susceptibility to meningococcal infections.
• Seroagglutination can segregate meningococci into 13 serogroups: A, B, C, D, X, Y, Z, E, W-135, H, I, K, and L. Ninety-eight percent of infections are caused by encapsulated serogroups A, B, C, Y, and W-135.
• Recurrent meningococcemia has also been reported with immunoglobulin G2 subclass deficiency.

Signs and Symptoms of Meningococcemia

Sign and symptoms may include the following :

• Nausea and vomiting.
• Severe headache.
• Fever
• Stiff neck.
• High fever .
• Sensitivity to light (photophobia) .
• Irritability .

Treatment for Meningococcemia

Immediate treatment of a suspected case of meningococcemia begins with antibiotics that work against the organism. Possible choices include penicillin G, ceftriaxone (Rocephin), cefotaxime (Claforan), or trimethoprim/sulfamethoxazole (Bactrim, Septra). For the patient who is allergic to penicillin, chloramphenicol I.V is used. Therapy may also include mannitol for cerebral edema, I.V. heparin for disseminated intravascular coagulation (DIC), dopamine for shock, and digoxin and a diuretic if heart failure develops. Supportive measures include fluid and electrolyte maintenance, proper ventilation (patent airway and oxygen if necessary), insertion of an arterial or central venous pressure (CVP) line to monitor cardiovascular status, and bed rest. Chemoprophylaxis with rifampin or minocycline is useful for facility workers who come in contact with the patient; minocycline can also temporarily eradicate the infection in carriers.

Treatment may include:

• Antibiotics such as ceftriaxone are prescribed and given intravenously for this disease. Other medicines may be used to treat the complications arising from the increased spinal fluid pressure.
• High doses of corticosteroids may be given for shock (must be given early).
• Sometimes steroid medication is used, more often in children than adults.
• Patients are often admitted to the intensive care unit of the hospital. Intensive monitoring and treatment are needed.