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Meningitis - meningococcal
Meningococcal meningitis; Gram negative - meningococcus
Meningitis is an infection of the membranes covering the brain and spinal cord. This covering is called the meninges.
Bacteria are one type of germ that can cause meningitis. The meningococcal bacteria is one kind of bacteria that causes meningitis.
Causes
Meningococcal meningitis is caused by the bacteria Neisseria meningitidis (also known as meningococcus).
Meningococcus is the most common cause of bacterial meningitis in children and teens. It is a leading cause of bacterial meningitis in adults.
The infection occurs more often in winter or spring. It may cause local epidemics at boarding schools, college dormitories, or military bases.
Risk factors include recent exposure to someone with meningococcal meningitis and a recent upper respiratory infection.
Symptoms
Symptoms usually come on quickly, and may include:
-
Fever
and chills
Fever
Fever is the temporary increase in the body's temperature in response to a disease or illness. A child has a fever when the temperature is at or abov...
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Mental status changes
Mental status changes
Confusion is the inability to think as clearly or quickly as you normally do. You may feel disoriented and have difficulty paying attention, remembe...
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-
Purple, bruise-like areas (
purpura
)
Purpura
Purpura is purple-colored spots and patches that occur on the skin, and in mucus membranes, including the lining of the mouth.
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Rash
, pinpoint red spots (
petechiae
)
Rash
Rashes involve changes in the color, feeling or texture of your skin.
ImageRead Article Now Book Mark ArticlePetechiae
Bleeding into the skin can occur from broken blood vessels that form tiny red dots (called petechiae). Blood also can collect under the tissue in la...
ImageRead Article Now Book Mark Article - Sensitivity to light ( photophobia )
- Severe headache
- Stiff neck
Other symptoms that can occur with this disease:
- Agitation
-
Bulging fontanelles
in infants
Bulging fontanelles
A bulging fontanelle is an outward curving of an infant's soft spot (fontanelle).
ImageRead Article Now Book Mark Article - Decreased consciousness
- Poor feeding or irritability in children
- Rapid breathing
-
Unusual posture with the head and neck arched backwards (
opisthotonus
)
Opisthotonus
Opisthotonos is a condition in which a person holds their body in an abnormal position. The person is usually rigid and arches their back, with thei...
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Exams and Tests
The health care provider will perform a physical exam. Questions will focus on symptoms and possible exposure to someone who might have the same symptoms, such as a stiff neck and fever.
If the provider thinks meningitis is possible, a lumbar puncture ( spinal tap ) will likely be done to remove a sample of spinal fluid for testing.
Spinal tap
Cerebrospinal fluid (CSF) collection is a test to look at the fluid that surrounds the brain and spinal cord. CSF acts as a cushion, protecting the b...
Other tests that may be done include:
-
Blood culture
Blood culture
A blood culture is a laboratory test to check for bacteria or other germs in a blood sample.
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Chest x-ray
Chest x-ray
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
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CT scan of the head
CT scan of the head
A head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.
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White blood cell (WBC) count
White blood cell (WBC) count
A WBC count is a blood test to measure the number of white blood cells (WBCs) in the blood. WBCs help fight infections. They are also called leukocy...
ImageRead Article Now Book Mark Article - Gram stain, other special stains
Treatment
Antibiotics will be started as soon as possible.
- Ceftriaxone is one of the most commonly used antibiotics.
- Penicillin in high doses is almost always effective.
- If there is an allergy to penicillin, chloramphenicol may be used.
Sometimes, corticosteroids are given to children.
People in close contact with someone who has meningococcal meningitis should be given antibiotics to prevent infection.
Such people include:
- Household members
- Roommates in dormitories
- Those who come into close and long-term contact with an infected person
Outlook (Prognosis)
Early treatment improves the outcome. Death is possible. Young children and adults over age 50 have the highest risk of death.
Possible Complications
Long-term complications may include:
- Brain damage
- Hearing loss
-
Hydrocephalus
(buildup of fluid inside the skull that leads to brain swelling)
Hydrocephalus
Hydrocephalus is a buildup of fluid inside the skull that leads to brain swelling. Hydrocephalus means "water on the brain. "
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Buildup of fluid between the skull and brain (
subdural effusion
)
Subdural effusion
A subdural effusion is a collection of cerebrospinal fluid (CSF) trapped between the surface of the brain and the outer lining of the brain (the dura...
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Inflammation of the heart muscle (
myocarditis
)
Myocarditis
Myocarditis is inflammation of the heart muscle. The condition is called pediatric myocarditis when it occurs in children.
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Seizures
Seizures
A seizure is the physical findings or changes in behavior that occur after an episode of abnormal electrical activity in the brain. The term "seizure...
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When to Contact a Medical Professional
Call the local emergency number (such as 911) or go to an emergency room if you suspect meningitis in a young child who has the following symptoms:
- Feeding difficulties
- High-pitched cry
- Irritability
- Persistent unexplained fever
Call the local emergency number if you develop any of the serious symptoms listed above. Meningitis can quickly become a life-threatening illness.
Prevention
Close contacts in the same household, school, or day care center should be watched for early signs of the disease as soon as the first person is diagnosed. All family and close contacts of this person should begin antibiotic treatment as soon as possible to prevent spread of the infection. Ask your provider about this during the first visit.
Always use good hygiene habits, such as washing hands before and after changing a diaper or after using the bathroom.
Vaccines for meningococcus are effective for controlling spread. They are currently recommended for:
Vaccines for meningococcus
All content below is taken in its entirety from the CDC Serogroup B Meningococcal Vaccine Information Statement (VIS): www. cdc. gov/vaccines/hcp/vis...
- Adolescents
- College students in their first year living in dormitories
- Military recruits
- Travelers to certain parts of the world
References
Pollard AJ, Sadarangani M. Neisseria meningitides (meningococcus). In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 191.
Stephens DS, Apicella MA. Neisseria meningitidis . In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, Updated Edition . 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 213.
Review Date: 7/31/2016
Reviewed By: 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, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
