Meningococcal disease | Disease of Neisseria meningitidis

Neisseria meningitidis is a bacterium that causes a disease called meningococcal disease. There are two types of diseases that are caused by Neisseria meningitidis. These are meningococcemia and meningococcal meningitis.

Meningococcemia is an infection caused in blood, while the infection in membranes surrounding the spinal cord and brain is named as meningococcal meningitis. Neisseria meningitidis may cause one or even both types of infections in an individual at a time.

It is a kind of medical emergency. If the patient shows any kind of symptoms related to a meningococcal disease then the patient requires immediate hospitalization.

If the hospitalization is delayed for a few hours it can prove life-threatening. 

Causes of meningococcal disease

Meningococcal disease is generally caused by a bacterium named Neisseria meningitidis. 10% of people usually have this bacterium in the back area of their throat and nose but this does not show any symptom related to a disease (as a carrier).  These bacteria sometimes penetrate into an individual’s body and cause meningococcal disease.

Types of meningococcal disease

Neisseria meningitidis are of five types which are named as A, B , C ,W ,Y. 

B, C and Y are usually the cause of meningococcal disease in most cases.

Spreading:

Bacteria of meningococcal disease spread from one person to another via secretions of the throat and respiratory tract. It can spread during kissing, coughing and other types of these close contacts. This bacterium can spread in close contact as well as at distant contact.

Symptoms of meningococcal disease

The following are the symptoms that are generally found in a meningococcal patient.

  •       The most common symptom which occurs about 75% of patients is purpura. Purpura is the appearance of small spots of purple or red color.
  •       Symptoms may also include blanching rashes but this symptom does not occur in  all of the patients
  •       Children of one year, as well as adults, may show severe headaches, stiffness of neck, vomiting, nausea, fever, and pain in neck and back.
  •       Sensitivity to light is increased pain in the thigh and lower back.                   Unconsciousness.
  •       Infants may refuse food and their sleep is increased.
  •       At head, some soft type of spots may appear.
  •       Low blood pressure decreased the flow of blood decreased amount of urine may occur.

Risk factors:

In most of the individuals having meningococcal bacteria are usually healthy and has no symptoms of the disease but some groups of bacteria can increase the risk of developing meningococcal disease.

  •       Those individuals that do not have spleens are at high risk.
  •       Young kids of six months to four years may have an increased risk of meningococcal disease especially those kids which are not fed on mother milk.
  •       People using immunity suppressing drugs.
  •   Frequently infected individuals deficiency of those compliments which are required by the immune system to break down the bacteria causing meningococcal disease.
  •   People living in relation to meningococcal disease patients are also at high risk of getting meningococcal disease.

Diagnosis 

Both types of meningococcal infections are usually inspected by physical examination of patients as well as the medical history of the patient.

Confirmation of meningococcal disease can also be made by lumbar puncture and blood culture. In lumbar puncture usually, CSF (cerebrospinal fluid) is taken from the lower back with the help of a needle.

If there is an increased amount of WBCs in this CSF (i.e more than 5cells/ microliter) then it indicates the presence of meningococcal meningitis.

If a patient has an increased pressure within the cranium may also require CT scanning.

Treatment of meningococcal disease

In the case of meningococcemia, the recognition of infection at an early stage is very crucial because it spreads very quickly and a patient may die within a few hours after symptoms.

At the start of infection, patients have some rashes only and it does not look unwell. Meningococcemia is very lethal and can cause rapid death of patients as compared to any other infection disorder.

The patient of meningococcemia as well as meningococcal meningitis requires immediate hospitalization and treatment. Most of the meningococcal disease patients required to be admitted in ICU.

The patient is initially treated with antibiotics and penicillin is the prime antibiotic. Recent researches show that some sort of Neisseria meningitidis can resist penicillin.

if bacteria are resistant to penicillin and cephalosporins is the best alternative. If the patient has severe sickness then treatment is a combination of penicillin and cephalosporins.

Treatment may also involve the following 

  •   In case of shock, organ damage is prevented by IV fluids.
  •   The patient with very decreased BP is treated with noradrenaline.
  •   Platelets and fresh plasma with other blood products is also used as a treatment in the case of meningococcemia.
  •   In case of decreased breath is treated by providing oxygen to the cylinders by machine.
  •   If a patient is successful in surviving meningococcemia he may face a severe cell death in the skin as well as tissues beneath the skin.

Complications about meningococcal disease

  •   In acute meningococcal disease or when a patient is recovering complications can occur. Some of these complications are so fatal that the chances of patient survival are decreased.
  •   Adrenal glands may massive hemorrhage.
  •   DIC may occur as a complication. In DIC clotting of blood is prevented.
  •   Amputation
  •   Arthritis
  •   Nerves in hands and feet are damaged which is called peripheral neuropathy. In addition to it some other neurologic disorders may also occur as complications.
  •   A condition of permanent muscle and skeletal problems may also occur.
  •   Heart problems such as inflammation in those sacs which surround the heart may also occur as complications. This inflammation is the heart surrounding sacs is named as pericarditis.

Preventions:

Usually, meningococcal disease is prevented in two ways. The first way is the immunoprophylaxis vaccine which is injected into patients as a preventive measure. It is also termed as immunization. The second way of prevention is antibiotic therapy in case of close contact. Antimicrobial chemoprophylaxis is used as antibiotic therapy.

People must avoid close contact with a patient of meningococcal disease. The patient of meningococcal disease must use a mask and handkerchief while coughing at public places in order to avoid the spreading of meningococcal disease.

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