| Disease/Syndrome |
Meningococcal infection |
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| Category |
Infection, Occupational |
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| Acute/Chronic |
Acute-Severe |
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| Synonyms |
Neisseria meningitidis infection |
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| Biomedical References |
Search PubMed |
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| Comments |
FINDINGS: The rash is distinctive in its early onset (within 2 hours of fever), distribution (appears on ankles, wrists, and armpits), and character (petechial with discrete lesions 1-2 mm in diameter on the trunk and lower extremities). The rash usually spares the palms and soles. It may appear as papules initially, but quickly progresses to petechiae and purpura. Ecchymoses are common at points of pressure from clothing such as underwear and stockings. Rubella-like and vesicular rashes have been described in some patients. Patients may have pharyngitis. Patients with fulminant disease develop widespread ecchymoses and purpura. In these patients the WBC count may be either high or low, and thrombocytopenia and intravascular coagulation are common. Disseminated intravascular coagulation (DIC) and multi-organ failure occur in meningococcal sepsis. Signs of DIC include enlarging petechiae, oozing at IV sites, and gingival and gastric bleeding. Other complications are pneumonia, arthritis, myocarditis, pericarditis, pulmonary edema, and cranial nerve palsies. Congestive heart failure caused by myocarditis is common in fatal cases. [CCDM, p. 359-60; Guerrant, p. 315-17; ID, p. 58-60, 1653; PPID, p. 2592-6; Fever and rash in the immunocompetent patient. UpToDate Online 12.2; Harrison, Table 142.1] EPIDEMIOLOGY: Meningococci in serogroups A, B, and C cause most outbreaks. The highest incidence of diseases occurs in children and young adults with a 5% to 10% mortality rate despite optimal treatment. An epidemic occurs about every 8-12 years in the meningitis belt in sub-Saharan Africa in the dry season between January and June. [Guerrant, p. 176-7] PREVENTION: "In rare instances, when proper precautions were not used, N. meningitidis has been transmitted from patient to personnel, through contact with the respiratory secretions of patients with meningococcemia or meningococcal meningitis, or through handling laboratory specimens. . . . Postexposure prophylaxis is advised for persons who have had intensive, unprotected contact (i.e., without wearing a mask) with infected patients (e.g., mouth-to-mouth resuscitation, endotracheal intubation, endotracheal tube management, or close examination of the oropharynx of patients)." [Guidelines for Infection Control in Health Care Personnel. CDC. 1998] Vaccination is recommended for travelers to the sub-Saharan "meningitis belt" during the dry season, especially if prolonged contact with people is anticipated. [CDC Travel, p. 243] |
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| Latency/Incubation |
2-10 days, usually 3-4 days; |
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| Diagnostic |
Culture; Positive Gram stains: 70% of aspirants from petechial lesions and 70% of CSF samples in untreated cases; CSF or urine antigen detection helpful when Gram stains negative; [Guerrant, p. 318-9] PCR of CSF has >90% Sn and Sp. [PPID, p. 2506] |
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| ICD-9 Code |
036 |
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| Available Vaccine |
Yes |
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| Effective Antimicrobics |
Yes |
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| Reference Link |
CDC - Meningococcal Meningitis |
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| Related Information in Haz-Map |
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| Symptoms/Findings |
Symptoms/Findings associated with this disease:
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| Job Tasks |
High risk job tasks associated with this disease:
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