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

Alternative Names

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

Causes, incidence, and risk factors

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.

Signs and tests

CBC

with differential

Blood culture

Gram stain of positive culture

Skin biopsy and Gram stain

Urinalysis

Clotting studies (

PT , PTT )

Treatment

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 areas of skin

Respiratory

isolation for first 24 hours, to avoid spread to other patients

Expectations (prognosis)

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. The absence of meningitis tends to have a poorer prognosis.

Complications

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

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

Prevention

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