Meningococcemia

Overview

Meningococcemia is an acute and potentially life-threatening infection of the bloodstream that commonly leads to vasculitis (inflammation of the blood vessels).

Symptoms

There may be few symptoms at first. Some may include: * Anxiety * Fever * Irritability * Spotty red or purple rash (petechiae) Additional symptoms may include: * Headache * Muscle and joint pain * Nausea * Vomiting Later symptoms may include: * Changing level of consciousness * Ill appearance * Large areas of bleeding under the skin (purpura) * Shock

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.

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 available, and has been suggested for use by college students who live in dormitories. You should discuss the appropriate use of this vaccine with your health care provider.

Diagnosis

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 obtain spinal fluid sample for CSF culture * Skin biopsy and gram stain * Urinalysis

Prognosis

Early treatment results in a good outcome. When shock develops, the outcome is more guarded. The condition is most life threatening in those who have: * Kidney failure * DIC (a severe bleeding disorder) * Profound shock Patients who do not develop meningitis also tend to have a poorer prognosis.

Treatment

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) * Breathing support * Clotting factors or platelet replacement -- if bleeding disorders develop * Fluids through a vein (IV) * Medications to treat blood pressure problems * Wound care for areas of skin with blood clots