MENINGOCOCCEMIA

Etiologic AgentGram negative bacteria caused Neisseria

Meningitidis, a Gram negative diplococcus.

Source ofInfectionDirect contact with respiratory droplets from

nose and throat of infected persons.

DescriptionThe disease is usually sporadic.Primarily a disease of children.May occur among adults especially in

conditions of forced overcrowding.It occurs more in males than in females,

young children (under 5 years), young teenagers and in young adult.

Increased rate in smokers, overcrowded households and military recruits.

Mode of TransmissionDirect contact

with respiratory droplets from nose and throat of infected persons.

Carrier may exist without cases of meningitis.

Transmission through inanimate objects.

Incubation Period2-10 days with an average of 3-4 days.

Signs and SymptomsHigh grade feverWeaknessJoint and muscle painHemorrhagic rashProgressing from few

petechiae to widespread purpura and ecchymoses

Meningeal irritation like headache

Nausea and vomitingStiff neckBulging fontanel

(among infants)Seizure or convulsionSensorial changes

Hemorrhagic Rash

Purpura

Ecchymoses

ComplicationsRaised intra-cranial

pressure.Disseminated

intravascular coagulation

SeizuresCirculatory collapseOrgan failureDeafness

BlindnessLasting neurological

deficitsReduced IQGangrene leading to

amputations

Disseminated Intravascular Coagulation

Gangrene

Methods of Prevention and ControlRespiratory isolation of patients for 24 hours.Hospital personnel are required to wear

mask, gloves, goggles and gown especially when doing endo-tracheal incubation.

ChemoprophylaxisThe public should be educated to avoid

overcrowded places.Only those with intimate exposure to naso-

pharyngeal secretion or unprotected exposure during endo-tracheal incubation warrants chemophrophylaxis.

TreatmentTreatment in primary care usually involves prompt

intramuscular administration of benzylpenicillin and then an urgent transfer to hospital for further care.

Once in hospital, the antibiotics of choice are usually IV broad spectrum 3rd generation cephalosporins, e.g.cefotaxime or ceftriaxone.

Benzylpenicillin and chloramphenicol are also effective.Supportive measures include IV fluids, oxygen,

inotropic support, e.g. dopamine or dobutamine and management of raised intracranial pressure.

Steroid therapy may help in some adult patients, but is unlikely to affect long term outcomes.

Nursing CareThe patient must be given chemoprophylaxis

before discharge to assure the elimination of meningococcus in the naso-pharyx.

Observe infection control measures like proper washing of hands with soap and water and other respiratory isolation especially for the first 24 hours upon admission.

Practice the gown technique including masks, goggles and gloves especially when doing endo-tracheal incubation.

Bear in mind other isolation technique like non-sharing of utensils, cups, lipstick, cigarettes and other water bottles, dishes and glasses. Don’t use also musical instruments, mouth guards or anything else that has been in the mouth of the infected person.

Health teachings regarding the importance of healthy diet, regular exercise, adequate sleep and rest and no alcohol and cigarette smoking.

Advice the importance of check-up after one week discharge, then monthly for those with complication (neurologic deficit) till improved and contact tracing.

Thank You!Reporters:Justin LucidoJaime MapanaoMa. Mercedita PaduaSherrylyn PerezSheila PinlacAllen RagasGeraldine RealRolando RioverosFaula RocamoraMarielle Ronquillo