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 a different way with meningococcal sepsis, according to statistics, the mortality rate is 75%. But even the survivors will no longer be completely healthy as before. The disease leaves a mark in the form of serious complications:
- mental retardation in children;
- hearing loss
- cranial nerve palsy;
- other cosmetic defects.
It is extremely rare that a chronic or recurrent course of the pathological process is observed. Bacteria die from exposure to direct sunlight for 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 mainly childish. The remaining 20% is the young generation aged 18-30.
Reasons for development and danger
Meningococcemia is a disease that is dangerous in that it arises suddenly, proceeds quickly, often taking a person’s life in just a few hours. Even with a conditionally mild course, children carry it extremely hard. The causative agent of the disease is the Neisseria meningitidis bacteria, and the source of infection can be a sick person or a recovered carrier, which has developed a stable immunity. The infection is transmitted by airborne droplets.
The incubation period is 5-6 days. The virus, once on the mucous membrane of the nasopharynx, causes an inflammatory process, provoking meningococcal nasopharyngitis in 95% of cases . With weakened immunity, microbes with lymph spread lightning fast throughout the body. Purulent meningitis occurs, and if the patient is not urgently provided with qualified medical care, pus will enter the brain and the person will die. If the patient survives, a lot of time may be required for rehabilitation and full recovery.
Symptoms
Meningococcemia is a disease that is characterized by an acute course, the sudden onset and development of clinical symptoms. The first sign that a person does not even pay attention to is an increase in temperature. After a few hours, 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 in any area of the skin, at first it is pink-red in color, gradually darkens and acquires a purple hue, almost black.
The first elements are more common on the buttocks and legs, then there is a spread throughout the body. The tissues of the internal organs and mucous membranes are also affected.
The patient’s condition worsens very quickly, body temperature may rise above 41 ° C, with a severe diffuse headache, a normal rhythm of the heartbeat, and severe muscular-joint ailments.
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 healthy, strong young people. Almost every case is fatal. The onset is acute: body temperature rises sharply, chills appear. The rash with meningococcemia from the first hours is plentiful in sizes of 10-15 cm, 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;
- damage to the central nervous system;
- meningitis - in 50-88% of cases;
- hypotension;
- meninges;
- loss of consciousness;
- bacterial endocarditis;
- septic arthritis;
- purulent pericarditis;
- adrenal hemorrhage (Waterhouse-Friedericksen syndrome);
- repeated vomiting.
The neurological status of patients is changing: 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 and 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;
- prednisone - single 2-5 mg.
During transportation to the hospital with signs of toxic toxic shock, infusion therapy is carried out to detoxify and dehydrate.
Diagnosis of the 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 begin treatment without waiting for the results of a laboratory study:
The main diagnostic methods:
- clinical blood test;
- cerebrospinal fluid examination;
- bacteriological method;
- serological testing;
- PCR research - detection of DNA of meningococcus.
The last analysis is the most accurate, but it is not carried out in all clinics, and the disadvantage of this method is the inability to determine the sensitivity of bacteria to a specific group of antibiotics.
Emergency treatment and rehabilitation
Treatment for meningococcemia begins immediately at the first sign of a suspected illness. A patient with a generalized form of meningococcal infection is subject to emergency hospitalization. Mandatory antibiotics are prescribed - chloramphenicol succinate. With an ultrafast course of the disease, the drug is administered every 4 hours intravenously. After the blood pressure stabilizes, the medicine is administered intramuscularly. The duration of therapy is 10 days or more.
Symptoms of intoxication are removed by the following drugs:
- detoxification agents: Ringer's solution, 5% glucose solution;
- "Furosemide" - to prevent cerebral edema;
- preparations for seizures (Sibazon);
- vitamins of group C, B;
- glutamic acid;
- glucocorticosteroids.
Also, medicines from the group of cephalosporins are used: "Cefotaxime", "Ceftriaxone".
Symptomatic antibiotic therapy:
- washing the nose with antiseptic agents;
- antipyretic drugs;
- glucose solution (intravenously);
- hormonal products;
- vitamin complexes;
- antihistamines and diuretics.
Treatment of meningococcemia in children is possible only in a hospital setting.
Important! With kidney problems, the doses of drugs are selected individually. Chloramphenicol 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 immediately established correctly, and treatment with hormones and antibiotics begins immediately. In order not to aggravate the shock state, a bactericidal antibiotic is administered and intensive infusion therapy is carried out.
Proven and verified - the bacterial load during first aid determines the prognosis of meningococcemia, enhancing 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 a full range of drugs available to provide emergency care to patients with this diagnosis.
Preventive measures
Meningococcemia is an infection that is extremely difficult to insure against. Preventive measures do not give a 100% guarantee of safety. However, the likelihood of infection is significantly reduced. The most effective preventive measures:
- timely vaccination;
- intake of vitamins;
- general hardening of the body;
- quarantine compliance;
- the elimination of hypothermia.
- preventive antibiotic prophylaxis
In any form, meningococcemia is a very serious disease. This requires qualified diagnostics and immediate comprehensive treatment. Thanks to modern technical equipment of clinics and the availability of required medicines, the mortality rate from this disease is reduced.