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Meningococcal disease: a case report and discussion of clinical presentation and management

Yıl 2012, Cilt: 17 Sayı: 1, 40 - 45, 24.01.2013

Öz

Abstract. Meningococcal disease caused by the gram negative diplococcus Neisseria meningitidis is a relatively common infectious disease in developing countries of Asia and Africa. Infection usually starts with a non-specific prodrome of fever, vomiting, malaise and lethargy followed by signs of septicemia and shock (tachycardia, tachypnea, cyanosis, oliguria, hypotension) and/or meningitis (stiff neck, headache, photophobia and impaired sensorium). Characteristic meningococcal rash may not appear early in the disease course, potentially delaying the diagnosis and institution of appropriate antibiotic therapy in the patient and isolation and chemoprophylaxis in close contacts. We present here a patient who presented with meningococcal shock associated with characteristic skin lesions of meningococcemia and discuss the clinical presentation and management.  The importance of early identification of the characteristic skin lesions of meningococcemia and timely institution of appropriate antibiotic therapy is emphasized.

Key words: Meningitis, meningococcal meningitis, meningococcal septicemia,  meningococcal shock syndrome


Kaynakça

  • Stephens DS, Greenwood B, Brandtzaeg P. Epidemic meningitis, meningococcaemia, and Neisseria meningitidis. Lancet 2007; 369: 2196-2210.
  • Nair D, Dawar R, Deb M, et al. Outbreak of meningococcal disease in and around New Delhi, India, 2005-2006: a report from a tertiary care hospital. Epidemiol Infect 2009; 137: 570-576.
  • Stein-Zamir C, Abramson N, Zentner G, et al. Invasive meningococcal disease in children in Jerusalem. Epidemiol Infect 2008; 136: 782-789.
  • Saha R, Gadre D, Mathur M. Meningococcaemia: experience at a tertiary care hospital in East Delhi. Indian J Med Microbiol 2006; 24: 299-300.
  • Shah A, Lettieri CJ. Fulminant meningococcal sepsis in a woman with previously unknown hyposplenism. Medscape J Med 2008; 10: 36.
  • Van Deuren M, van Dijke BJ, Koopman RJ, et al. Rapid diagnosis of acute meningococcal infections by needle aspiration or biopsy of skin lesions. BMJ 1993; 306: 1229-1232.
  • Yung AP, McDonald MI. Early clinical clues to meningococcaemia. Med J Aust 2003; 178: 134-137.
  • London V, Aronowitz P. Purpuric rash of meningococcemia. J Hosp Med 2008; 3: 169.
  • Hachimi-Idrissi S, Corne L, Ramet J. Evaluation of scoring systems in acute meningococcaemia. Eur J Emerg Med 1998; 5: 225-230.
  • Visintin C, Mugglestone MA, Fields EJ, et al. Guideline Development Group; National Institute for Health and Clinical Excellence. Management of bacterial meningitis and meningococcal septicemia in children and young people: summary of NICE guidance. BMJ 2010; 340: c3209. doi: 10.1136/bmj.c3209.
  • Van Waardenburg DA, Jansen TC, Vos GD, Buurman WA. Hyperglycemia in children with meningococcal sepsis and septic shock: the relation between plasma levels of insulin and inflammatory mediators. J Clin Endocrinol Metab 2006; 91: 3916-3921.
  • Branco RG, Russell RR. Should steroids be used in children with meningococcal shock? Arch Dis Child 2005; 90: 1195-1196.
  • van de Beek D, Farrar JJ, de Gans J, et al. Adjunctive dexamethasone in bacterial meningitis: a meta-analysis of individual patient data. Lancet Neurol 2010; 9: 254-263.
  • de Gans J, van de Beek D. European Dexamethasone in Adulthood Bacterial Meningitis Study Investigators. Dexamethasone in adults with bacterial meningitis. N Engl J Med 2002; 347: 1549-1556.
  • Wildes SS, Tunkel AR. Meningococcal vaccines: a progress report. BioDrugs 2002; 16: 321-329.
  • Shao ZJ, Li YX. Study progress on serogroup B meningococcal vaccine. Zhongguo Yi Miao He Mian Yi 2009; 15: 542-546.
  • Tan LKK, Carlone GM, Borrow R. Advances in the development of vaccines against Neisseria meningitidis. N Engl J Med 2010; 362: 1511-1520.
Yıl 2012, Cilt: 17 Sayı: 1, 40 - 45, 24.01.2013

Öz

Kaynakça

  • Stephens DS, Greenwood B, Brandtzaeg P. Epidemic meningitis, meningococcaemia, and Neisseria meningitidis. Lancet 2007; 369: 2196-2210.
  • Nair D, Dawar R, Deb M, et al. Outbreak of meningococcal disease in and around New Delhi, India, 2005-2006: a report from a tertiary care hospital. Epidemiol Infect 2009; 137: 570-576.
  • Stein-Zamir C, Abramson N, Zentner G, et al. Invasive meningococcal disease in children in Jerusalem. Epidemiol Infect 2008; 136: 782-789.
  • Saha R, Gadre D, Mathur M. Meningococcaemia: experience at a tertiary care hospital in East Delhi. Indian J Med Microbiol 2006; 24: 299-300.
  • Shah A, Lettieri CJ. Fulminant meningococcal sepsis in a woman with previously unknown hyposplenism. Medscape J Med 2008; 10: 36.
  • Van Deuren M, van Dijke BJ, Koopman RJ, et al. Rapid diagnosis of acute meningococcal infections by needle aspiration or biopsy of skin lesions. BMJ 1993; 306: 1229-1232.
  • Yung AP, McDonald MI. Early clinical clues to meningococcaemia. Med J Aust 2003; 178: 134-137.
  • London V, Aronowitz P. Purpuric rash of meningococcemia. J Hosp Med 2008; 3: 169.
  • Hachimi-Idrissi S, Corne L, Ramet J. Evaluation of scoring systems in acute meningococcaemia. Eur J Emerg Med 1998; 5: 225-230.
  • Visintin C, Mugglestone MA, Fields EJ, et al. Guideline Development Group; National Institute for Health and Clinical Excellence. Management of bacterial meningitis and meningococcal septicemia in children and young people: summary of NICE guidance. BMJ 2010; 340: c3209. doi: 10.1136/bmj.c3209.
  • Van Waardenburg DA, Jansen TC, Vos GD, Buurman WA. Hyperglycemia in children with meningococcal sepsis and septic shock: the relation between plasma levels of insulin and inflammatory mediators. J Clin Endocrinol Metab 2006; 91: 3916-3921.
  • Branco RG, Russell RR. Should steroids be used in children with meningococcal shock? Arch Dis Child 2005; 90: 1195-1196.
  • van de Beek D, Farrar JJ, de Gans J, et al. Adjunctive dexamethasone in bacterial meningitis: a meta-analysis of individual patient data. Lancet Neurol 2010; 9: 254-263.
  • de Gans J, van de Beek D. European Dexamethasone in Adulthood Bacterial Meningitis Study Investigators. Dexamethasone in adults with bacterial meningitis. N Engl J Med 2002; 347: 1549-1556.
  • Wildes SS, Tunkel AR. Meningococcal vaccines: a progress report. BioDrugs 2002; 16: 321-329.
  • Shao ZJ, Li YX. Study progress on serogroup B meningococcal vaccine. Zhongguo Yi Miao He Mian Yi 2009; 15: 542-546.
  • Tan LKK, Carlone GM, Borrow R. Advances in the development of vaccines against Neisseria meningitidis. N Engl J Med 2010; 362: 1511-1520.
Toplam 17 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Bölüm Case Report
Yazarlar

Pk Sethi Bu kişi benim

R Thukral Bu kişi benim

Nk Sethi Bu kişi benim

J Torgovnick Bu kişi benim

E Arsura Bu kişi benim

A Wasterlain Bu kişi benim

Yayımlanma Tarihi 24 Ocak 2013
Yayımlandığı Sayı Yıl 2012 Cilt: 17 Sayı: 1

Kaynak Göster

APA Sethi, P., Thukral, R., Sethi, N., Torgovnick, J., vd. (2013). Meningococcal disease: a case report and discussion of clinical presentation and management. EASTERN JOURNAL OF MEDICINE, 17(1), 40-45.
AMA Sethi P, Thukral R, Sethi N, Torgovnick J, Arsura E, Wasterlain A. Meningococcal disease: a case report and discussion of clinical presentation and management. EASTERN JOURNAL OF MEDICINE. Mart 2013;17(1):40-45.
Chicago Sethi, Pk, R Thukral, Nk Sethi, J Torgovnick, E Arsura, ve A Wasterlain. “Meningococcal Disease: A Case Report and Discussion of Clinical Presentation and Management”. EASTERN JOURNAL OF MEDICINE 17, sy. 1 (Mart 2013): 40-45.
EndNote Sethi P, Thukral R, Sethi N, Torgovnick J, Arsura E, Wasterlain A (01 Mart 2013) Meningococcal disease: a case report and discussion of clinical presentation and management. EASTERN JOURNAL OF MEDICINE 17 1 40–45.
IEEE P. Sethi, R. Thukral, N. Sethi, J. Torgovnick, E. Arsura, ve A. Wasterlain, “Meningococcal disease: a case report and discussion of clinical presentation and management”, EASTERN JOURNAL OF MEDICINE, c. 17, sy. 1, ss. 40–45, 2013.
ISNAD Sethi, Pk vd. “Meningococcal Disease: A Case Report and Discussion of Clinical Presentation and Management”. EASTERN JOURNAL OF MEDICINE 17/1 (Mart 2013), 40-45.
JAMA Sethi P, Thukral R, Sethi N, Torgovnick J, Arsura E, Wasterlain A. Meningococcal disease: a case report and discussion of clinical presentation and management. EASTERN JOURNAL OF MEDICINE. 2013;17:40–45.
MLA Sethi, Pk vd. “Meningococcal Disease: A Case Report and Discussion of Clinical Presentation and Management”. EASTERN JOURNAL OF MEDICINE, c. 17, sy. 1, 2013, ss. 40-45.
Vancouver Sethi P, Thukral R, Sethi N, Torgovnick J, Arsura E, Wasterlain A. Meningococcal disease: a case report and discussion of clinical presentation and management. EASTERN JOURNAL OF MEDICINE. 2013;17(1):40-5.