MedlinePlus Medical Encyclopedia: Meningococcemia

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Meningococcemia

Contents of this page:
Alternative names Definition Causes, incidence, and risk factors Symptoms Signs and tests	Treatment Expectations (prognosis) Complications Calling your health care provider Prevention

Alternative names

Meningococcal septicemia; Meningococcal blood poisoning; Meningococcal bacteremia or bacterial in the blood

Definition Return to top

Meningococcemia is an acute (sudden onset) infection of the bloodstream and subsequent vasculitis (inflammation of the blood vessels) caused by the bacteria Neisseria meningitidis.

Causes, incidence, and risk factors Return to top

Neisseria meningitidis frequently lives in the upper respiratory tract with no evidence of illness. Some event is thought to trigger the onset of aggressive behavior of the organism 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. It is transmitted from person-to-person by respiratory droplets.

Symptoms Return to top

Symptoms may be very few at first, and can include:

Fever
Petechial (spotty red or purple) rash
Irritability
Appears anxious

Later symptoms and signs can include:

Appears acutely ill
Changing level of consciousness
Shock
Large areas of hemorrhage and/or thrombosis under the skin

Signs and tests Return to top

CBC with differential
Blood culture
Gram stain of positive culture
Skin biopsy and Gram stain
Urinalysis
Clotting studies (PT, PTT)

Treatment Return to top

Patients are often admitted to the intensive care unit of the hospital. Intensive monitoring and treatment are needed.

Supportive measures for shock include:

IV fluids
Ventilatory support
Medical support of blood pressure

Medications include intravenous (IV) antibiotics to eliminate the infection, and high doses of corticosteroids for shock (must be given early). Clotting factors or platelet replacement may be needed if bleeding disorders develop.

Other treatments:

Wound care for thrombosed (with blood clots) areas of skin
Respiratory isolation for first 24 hours, to avoid spread to other patients

Expectations (prognosis) Return to top

Early treatment results in a good outcome. When shock develops, the outcome is more guarded. Profound shock, DIC (a severe bleeding disorder), and adrenal collapse all predispose the patient to a poor prognosis with possibility of a death. Patients without meningitis tend to have a poorer prognosis.

Complications Return to top

Profound shock
Limb loss secondary to clots (thrombosis)
Irreversible shock
Disseminated intravascular coagulopathy (DIC)
Waterhouse-Friderichsen syndrome
Arthritis
Cutaneous vasculitis (inflammation of blood vessels in the skin)
Pericarditis

Calling your health care provider Return to top

Call your health care provider immediately or go to the emergency room if your child has symptoms suggestive of meningococcemia.

Prevention Return to top

Prophylaxis (preventive antibiotics) for family members and contacts are often recommended. Speak with you health care provider about this option.

A vaccine that covers some but not all strains of meningococcus is available and has been suggested for use by college students. You should discuss the appopriate use of this vaccine with your health care provider.

Update Date: 1/16/2004

Updated by: Daniel Levy, M.D., Ph.D., Infectious Diseases, Greater Baltimore Medical Center, Baltimore, MD. Review provided by VeriMed Healthcare Network.

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