The Danger of Fatal Infections: Meningococcemia

Published: 23rd August 2010
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One of the most fatal of all meningococcal diseases is called meningococcemia, a bacterial infection in the bloodstream. It is so deadly that patients who do not get prompt treatment may die from respiratory or heart failure within 6 to 24 hours. However, according to the National Istitutes of Health, meningococcemia is considered a rare disease, which means it only affects less than 200,000 people in the US population. A consortium of European partners called Ophanet defines a condition rare when if affects 1person per 2,000.

Meningococcemia is just one of the two major meningococcal infections, the other one being meningitis, an ailment that is caused by the bacteria known as Neisseria meningitidis. This is the same strain which also causes primary pneumonia, purulent conjunctivitis, endocarditis, sinusitis, and genital infection.

Meningococcemia can cause severe illness in children and young adults and may produce death within hours. This condition is contagious since the bacteria can be spread from person to person through colonization of the upper airway without producing any sign or symptom. The bacteria then penetrate into the bloodstream to the central nervous system and cause meningitis, or may develop into a full-blown bloodstream infection which is meningococcemia.

Symptoms may develop within 24 hours to two weeks after colonization. At first, patients will start to complain of fever and muscle aches. In just a few hours, more severe symptoms may develop. During this early stage, a doctor may not be able to distinguish the condition from any other illness, such as a viral infection like influenza. Unless the person is known to have been exposed to or in the midst of an epidemic of meningococcal disease, there may be no specific symptoms or signs found that can help the doctor diagnose the problem.

As the bacteria continues to multiply and cause more damage, the patient will continue to complain of fever, chills and overwhelming weakness. The first sign occurs when there's severe inflammation of the small blood vessels walls called vasculitis. The damage causes the small vessels to leak which may appear as small bleeding spots on the skin, called petechiae. Acutely ill patients with fever, chills, and petechiae should always be suspected of having meningococcemia.

Within a few hours after infection, large bleeding areas on the skin known as purpura become more visible as the damage to the blood vessels increases. The blood pressure is often low and symptoms of bleeding from other organs occur like coughing up blood, nose bleeds, and blood in the urine become evident. While the damaged blood vessels continue to leak, clotting also occurs inside the vessels which may result in major tissue damage in the large arteries. This results to loss of blood and oxygen and may cause large areas of skin, muscle, and internal organs to die, putting the patient in high risk of dying.

Meningococcemia can be diagnosed through blood cultures by obtaining fluid from a petechial spot and staining it in the laboratory. However, as soon as diagnosis is suspected, treatment should not be delayed waiting for positive cultures. Antibiotics that work against the organism should be administered immediately. Patients diagnosed in a doctor's clinic should be given antibiotics even before hospital transfer. The speed of initial treatment will greatly affect the progress of the disease.

About 15-20% of patients with meningococcemia may die due to acute infection while a notable percentage of the survivors will have tissue damage that requires surgical treatment such as skin grafts, or even partial or full amputations of an arm or leg.

Although a vaccine for meningococcus is now being made available, it is recommended that people who have had contact with anyone who has meningococcal infection should take antibiotics immediately to minimize the risk of infection. The most common antibiotics given are rifampin (Rifadin) or ciprofloxacin (Cipro). which are usually taken by mouth twice a day for two days. Discuss this with your health care provider before taking any form of antibacterial or antiviral medication.

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