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    Meningococcemia

    Meningococcal septicemia; Meningococcal blood poisoning; Meningococcal bacteremia

    Meningococcemia is an acute and potentially life-threatening infection of the bloodstream.

    See also: Septicemia

    Causes

    Meningococcemia is caused by a bacteria called Neisseria meningitidis. The bacteria frequently lives in a person's upper respiratory tract without causing visible signs of illness. The bacteria can be spread from person to person through respiratory droplets -- for example, you may become infected if you are around someone with the condition when they sneeze or cough.

    Family members and those closely exposed to someone with the condition are at increased risk. The infection occurs more frequently in winter and early spring.

    Symptoms

    There may be few symptoms at first. Some may include:

    • Fever
    • Headache
    • Irritability
    • Muscle pain
    • Nausea
    • Rash with red or purple spots (petechiae)

    Later symptoms may include:

    • Changing level of consciousness
    • Large areas of bleeding under the skin (purpura)
    • Shock

    Exams and Tests

    Blood tests will be done to rule out other infections and help confirm meningococcemia. Such tests may include:

    • Blood culture
    • Complete blood count with differential
    • Clotting studies (PT, PTT)

    Other tests that may be done include:

    • Lumbar puncture to get a sample of spinal fluid for CSF culture
    • Skin biopsy and Gram stain
    • Urinalysis

    Treatment

    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

    Outlook (Prognosis)

    Early treatment results in a good outcome. When shock develops, the outcome is less certain.

    The condition is most life threatening in those who have:

    • Disseminated intravascular coagulopathy (DIC) - a severe bleeding disorder
    • Kidney failure
    • Shock

    Possible Complications

    • Arthritis
    • Disseminated intravascular coagulopathy (DIC)
    • Gangrene due to lack of blood supply
    • Inflammation of blood vessels in the skin (cutaneous vasculitis)
    • Myocarditis
    • Pericarditis
    • Shock
    • Severe damage to adrenal glands that can lead to low blood pressure (Waterhouse-Friderichsen syndrome)

    When to Contact a Medical Professional

    Go to the emergency room immediately if you have symptoms of meningococcemia. Call your doctor if you have been around someone with the disease.

    Prevention

    Preventive antibiotics for family members and contacts are often recommended. Speak with your health care provider about this option.

    A vaccine that covers some -- but not all -- strains of meningococcus is recommended for children age 11 or 12. A booster is given at age 16. Unvaccinated college students who live in dormitories should also consider receiving this vaccine. It should be given a few weeks before they first move into the dorm. Talk to your doctor about the appropriate use of this vaccine.

    References

    Apicella MA. Neisseria meningitidis. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 211.

    Stephens DS. Neisseria meningitidis infections. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 306.

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          Review Date: 10/6/2012

          Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

          The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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          St. Luke's Hospital - 232 South Woods Mill Road - Chesterfield, MO 63017 Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
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