Meningococcal septicaemia (Meningococcemia, Meningococcal bacteremia)

What is Meningococcal septicaemia?

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

Statistics on Meningococcal septicaemia?

The disease is carried asmptomatically in 5-20% of the population. It is found worldwide in 5 major serogroups. Group A meningococcus causes epidemic disease in sub-Saharan Africa and parts of Asia. Groups Y and W also cause epidemic infection. Groups B and C tend to cause sporadic infection in Europe and North America.

Risk Factors for Meningococcal septicaemia

The disease only occurs in a small percentage of those colonised. It depends on both host and bacterial factors and is more likely folllowing viral upper respiratory infections.

Progression of Meningococcal septicaemia

Man is the only known reservoir of the disease. The meningococcal disease occurs when bacteria invade the nasal mucosa and enter the bloodstream.

How is Meningococcal septicaemia Diagnosed?

A gram stain of cerebro spinal fluid (CSF) may show gram-negative diplococci. An aspirate (material drawn in negative pressure from a syringe) from petechiae and meningococci can also be cultured from CSF or blood and detected by PCR (polymerase chain reaction).

Prognosis of Meningococcal septicaemia

In developed countries there is a mortality rate of 10% from meningococcal septicaemia and 5% for meningococcal meningitis. Mild neurological sequelae such as vestibular nerve damage are common but serious brain damage is uncommon.

How is Meningococcal septicaemia Treated?

Benzyl penicillin 2.4g i.v. (slowly) should be given immediately for 7 days.
A vaccine against serogroup C is available.
Household, kissing or other close contacts of a case of meningococcal disease should be given oral rifampicin or ciproflaxin, (ciproflaxin should not be given to children), as prophylaxis.
Immunisation can be offered for a group C disease.