Meningococcemia is a pathology caused by the bacteria Neisseria meningitidis. It is a generalized form of meningococcal infection. The disease is characterized by an acute course and a variety of clinical symptoms.
With meningococcemia or, in other words, with meningococcal sepsis, according to statistics, the mortality rate is 75%. But even the survivors will no longer be completely he althy as before. The disease leaves a trail in the form of serious complications:
- mental retardation in children;
- hearing loss;
- cranial nerve palsies;
- other cosmetic defects.
It is extremely rare to observe a chronic or recurrent course of the pathological process. Bacteria die from exposure to direct sunlight within 2-8 hours, the seasonal rise is winter and spring.
In 80% of cases, the infection affects children aged 1 to 5 years, so the disease is considered predominantly in children. The remaining 20% is the younger generation aged 18-30.
Reasons for development anddanger
Meningococcemia is a disease that is dangerous because it occurs suddenly, proceeds quickly, often taking a person's life in just a few hours. Even with a relatively mild course, children endure it extremely hard. The causative agent of the disease is the bacteria Neisseria meningitidis, and the source of infection can be a sick person or a recovered carrier who has developed strong immunity. The infection is transmitted by airborne droplets.
The incubation period is 5-6 days. The virus, once on the nasopharyngeal mucosa, causes an inflammatory process, provoking meningococcal nasopharyngitis in 95% of cases. With a weakened immune system, microbes with lymph spread at lightning speed throughout the body. There is purulent meningitis, and if the patient is not urgently provided with qualified medical care, the pus will enter the brain and the person will die. If the patient survives, it may take a lot of time for rehabilitation and full recovery.
Manifestation of symptoms
Meningococcemia is a disease that is characterized by an acute course, sudden onset and development of clinical symptoms. The first sign that a person will not even pay attention to is an increase in temperature. A few hours later, a characteristic skin rash occurs only for this disease. In a typical course, it is hemorrhagic, stellate with necrosis in the center. A severe course is accompanied by necrosis of the fingers and toes, continuous hemorrhages appear. The rash with meningococcemia is localized on any part of the skin, at first it is pink-redcolor, gradually darkens and acquires a purple hue, almost black.
The first elements are more common on the buttocks and legs, then it spreads throughout the body. The tissues of internal organs and mucous membranes are also affected.
The patient's condition is deteriorating very quickly, body temperature may rise above 41 °C, with a severe diffuse headache, the normal rhythm of the heartbeat is disturbed, severe muscle and joint ailments appear.
Degrees of severity
Meningococcemia in children occurs in moderate, severe and hypertoxic form. The latter manifests itself in babies with good immunity, with proper nutrition and in physically he althy, strong young people. Almost every case is fatal. The onset is acute: body temperature rises sharply, chills appear. Rash with meningococcemia from the first hours abundant reaches 10-15 cm in size, dry gangrene of the auricles, tip of the nose and fingers is formed. In the absence of qualified assistance, death will occur within 20-48 hours from the onset of the disease.
Complications and signs
Other common symptoms of meningococcemia:
- extreme weakness;
- internal and external bleeding (nasal, gastrointestinal, uterine);
- tachypnea (frequent shallow breathing);
- tachycardia;
- CNS lesion;
- meningitis - in 50-88% of cases;
- hypotension;
- irritation of the meninges;
- loss of consciousness;
- bacterial endocarditis;
- septic arthritis;
- purulent pericarditis;
- hemorrhages in the adrenal glands (Waterhouse-Friderichsen syndrome);
- repeated vomiting.
The neurological status of patients changes: they become extremely withdrawn, as in a coma, or, conversely, overexcited.
First aid for meningococcemia
Emergency first aid is provided in two stages: at home and in the hospital. Sometimes the pre-hospital stage is the most important. Therefore, it is necessary to know about the features of the course of the disease not only for medical specialists, but also for patients, as well as parents. With a generalized form of meningococcal infection at home, the patient is injected intramuscularly per 1 kg of body weight:
- chloramphenicol sodium succinate - in a single dose of 25 thousand units;
- benzylpenicillin - 200-400 thousand units per day,;
- prednisolone - one-time 2-5 mg.
During transportation to the hospital with signs of infectious-toxic shock, infusion therapy is carried out for detoxification and dehydration.
Diagnosis of disease
The final diagnosis that this is meningococcemia, even with pronounced symptoms, can only be made after laboratory testing. However, the pathology progresses at lightning speed and is characterized by high mortality, so it is reasonable to start treatment without waiting for the results of a laboratory test:
Basic diagnostic methods:
- CBC;
- study of cerebrospinal fluid;
- bacteriological method;
- serological testing;
- PCR study - detection of meningococcal DNA.
The last analysis is the most accurate, but it is not carried out in all clinics, and the disadvantage of this method is the impossibility of determining the sensitivity of bacteria to a particular group of antibiotics.
Emergency treatment and rehabilitation
Treatment of meningococcemia begins immediately at the first sign of suspected disease. A patient with a generalized form of meningococcal infection is subject to emergency hospitalization. Antibiotics are mandatory - chloramphenicol succinate. With an ultra-fast course of the disease, the drug is administered intravenously every 4 hours. After the blood pressure stabilizes, the drug is administered intramuscularly. Duration of therapy 10 days or more.
Symptoms of intoxication of the body are removed by the following drugs:
- detoxification agents: Ringer's solution, 5% glucose solution;
- "Furosemide" - to prevent cerebral edema;
- drugs for convulsions ("Sibazon");
- vitamins C, B;
- glutamic acid;
- glucocorticosteroids.
Medications from the cephalosporin group are also used: Cefotaxime, Ceftriaxone.
Symptomatic antibiotic therapy:
- rinsing the nose with antiseptics;
- antipyretic drugs;
- glucose solution (intravenous);
- hormonal products;
- vitamin complexes;
- antihistamines and diuretics.
Treatment of meningococcemia in children is possible only in a hospital setting.
Important! In case of problems with the kidneys, the doses of drugs are selected individually. Levomycetin often provokes aplastic anemia.
Chance of Survival
Even with lightning-fast development and severe course of meningococcemia, the patient has a chance to survive, provided that the diagnosis is established immediately without error, and treatment with hormones and antibiotics begins immediately. In order not to aggravate the state of shock, a bactericidal antibiotic is administered and intensive infusion therapy is carried out.
Proven and proven - the bacterial load during first aid determines the prognosis of meningococcemia by increasing the breakdown of meningococcus in the bloodstream. Therefore, even before hospitalization, benzylpenicillin, third-generation cephalosporins are administered. The chances of survival are increased if the clinic has the full range of drugs available to provide emergency care to patients with this diagnosis.
Prevention measures
Meningococcemia is an infection that is extremely difficult to insure against. Preventive measures do not give a 100% guarantee of safety. However, the risk of infection is greatly reduced. Most Effective Prevention Measures:
- timely vaccination;
- taking vitamins;
- general hardening of the body;
- compliance with the quarantine regime;
- avoid hypothermia.
- preventive antibiotic prophylaxis
In any form, meningococcemia – is a very serious disease. This requires qualified diagnosis and immediate comprehensive treatment. Thanks to the modern technical equipment of clinics and the availability of the required medicines, the mortality rate from this disease is decreasing.
