Meningococcemia

Meningococcemia is an acute and potentially life-threatening infection of the bloodstream. See also: Septicemia Causes Meningococcemia is caused by a bacteria called Neisseria meningitidis. The bacteria frequently lives in a person's upper respiratory tract without causing visible signs of illness. The bacteria can be spread from person to person through respiratory droplets - for example, you may become infected if you are around someone with the condition when they sneeze or cough. Family members and those closely exposed to someone with the condition are at increased risk. The infection occurs more frequently in winter and early spring. Symptoms There may be few symptoms at first. Some may include: Anxiety Fever Headache Irritability Muscle pain Nausea Rash with red or purple spots (petechiae)

Later symptoms may include: Changing level of consciousness Large areas of bleeding under the skin (purpura) Shock

Exams and Tests Blood tests will be done to rule out other infections and help confirm meningococcemia. Such tests may include: Blood culture Complete blood count with differential Clotting studies (PT, PTT)

Other tests that may be done include:

Lumbar puncture to obtain spinal fluid sample for CSF culture Skin biopsy and gram stain Urinalysis

Treatment Meningococcemia is a medical emergency. Persons with this type of infection are often admitted to the intensive care unit of the hospital, where they are closely monitored. The person may be placed in respiratory isolation for the first 24 hours to help prevent the spread of the infection to others. Treatments may include: Antibiotics given through a vein (IV), given immediately Breathing support Clotting factors or platelet replacement -- if bleeding disorders develop Fluids through a vein (IV) Medications to treat low blood pressure Wound care for areas of skin with blood clots

Outlook (Prognosis) Early treatment results in a good outcome. When shock develops, the outcome is less certain. The condition is most life threatening in those who have: Disseminated intravascular coagulopathy (DIC) - a severe bleeding disorder Kidney failure Shock

Patients who do not develop meningitis also tend to have a poorer outcome. Possible Complications Arthritis Disseminated intravascular coagulopathy (DIC) Gangrene due to lack of blood supply Inflammation of blood vessels in the skin (cutaneous vasculitis) Myocarditis Pericarditis Shock

Severe damage to adrenal glands that can lead to low blood pressure (Waterhouse-Friderichsen syndrome)

When to Contact a Medical Professional Go to the emergency room immediately if you have symptoms of meningococcemia. Call your doctor if you have been around someone with the disease. Prevention Preventive antibiotics for family members and contacts are often recommended. Speak with your health care provider about this option. A vaccine that covers some -- but not all -- strains of meningococcus is recommended for children. Unvaccinated college students who live in dormitories should also consider receiving this vaccine. In this scenario, it should be given a few weeks before they first move into the dormitory. You should discuss the appropriate use of this vaccine with your health care provider. Alternative Names Meningococcal septicemia; Meningococcal blood poisoning; Meningococcal bacteremia References Apicella MA. Meningococcal infections. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 321.

Meningococcemia facts
Meningococcemia is a bloodstream infection cause by the bacteriumNeisseria meningitidis. N. meningitidis is a contagious bacterium and is spread from person to person via respiratory secretions. Initially, patients present with fever and general aches. A rash is often present. Patients with meningococcemia are seriously ill. Complications include shock, failure of multiple organs, lack of circulation to the extremities, and death. Patients may also develop or present with meningitis. Meningococcemia is treated with intravenous antibiotics. Case fatality rates are as high as 19% in industrialized countries. Early treatment reduces the risk of complications and death. A vaccine is available to help prevent four of the five most common serogroups that cause meningococcemia. The vaccine is recommended at 11 years of age, with a booster dose at 16 years of age.

 People who have a certain type of immune deficiency in the complement system and people with missing or damaged spleens are at increased risk and should be vaccinated. People who travel to areas where outbreaks are occurring should be vaccinated before travel. People who have had close contact with an infected patient (for example, a household member with face-to-face contact, a child's playmate, etc.) should receive antibiotics to reduce the risk of disease. These "prophylactic" antibiotics should be started as soon as possible but certainly within two weeks of exposure.

Meningococcemia
Meningococcal septicemia; Meningococcal blood poisoning; Meningococcal bacteremia
Last reviewed: September 15, 2010.

Meningococcemia is an acute and potentially life-threatening infection of the bloodstream. See also: Septicemia

Causes, incidence, and risk factors

Meningococcemia is caused by a bacteria called Neisseria meningitidis. The bacteria frequently lives in a person's upper respiratory tract without causing visible signs of illness. The bacteria can be spread from person to person through respiratory droplets - for example, you may become infected if you are around someone with the condition when they sneeze or cough. Family members and those closely exposed to someone with the condition are at increased risk. The infection occurs more frequently in winter and early spring.

Symptoms
There may be few symptoms at first. Some may include: Anxiety Fever Headache Irritability

Muscle pain Nausea Rash with red or purple spots (petechiae)

Later symptoms may include: Changing level of consciousness Large areas of bleeding under the skin (purpura) Shock

Signs and tests

Blood tests will be done to rule out other infections and help confirm meningococcemia. Such tests may include: Blood culture Complete blood count with differential Clotting studies (PT, PTT)

Other tests that may be done include: Lumbar puncture to obtain spinal fluid sample for CSF culture Skin biopsy and gram stain Urinalysis

Treatment
Meningococcemia is a medical emergency. Persons with this type of infection are often admitted to the intensive care unit of the hospital, where they are closely monitored. The person may be placed in respiratory isolation for the first 24 hours to help prevent the spread of the infection to others. Treatments may include: Antibiotics given through a vein (IV), given immediately Breathing support Clotting factors or platelet replacement -- if bleeding disorders develop Fluids through a vein (IV) Medications to treat low blood pressure Wound care for areas of skin with blood clots

Expectations (prognosis)
Early treatment results in a good outcome. When shock develops, the outcome is less certain. The condition is most life threatening in those who have:

Disseminated intravascular coagulopathy (DIC) - a severe bleeding disorder Kidney failure Shock

Patients who do not develop meningitis also tend to have a poorer outcome.

Complications
Arthritis Disseminated intravascular coagulopathy (DIC) Gangrene due to lack of blood supply Inflammation of blood vessels in the skin (cutaneous vasculitis) Myocarditis Pericarditis Shock Severe damage to adrenal glands that can lead to low blood pressure (Waterhouse-Friderichsen syndrome)

Calling your health care provider

Go to the emergency room immediately if you have symptoms of meningococcemia. Call your doctor if you have been around someone with the disease.

Prevention
Preventive antibiotics for family members and contacts are often recommended. Speak with your health care provider about this option. A vaccine that covers some -- but not all -- strains of meningococcus is recommended for children. Unvaccinated college students who live in dormitories should also consider receiving this vaccine. In this scenario, it should be given a few weeks before they first move into the dormitory. You should discuss the appropriate use of this vaccine with your health care provider

>>>Description Meningococcemia is an acute and potentially life-threatening infection of the bloodstream that commonly leads to vasculitis (inflammation of the blood vessels). Meningococcemia or meningococcal meningitis is an acute communicable infection caused by gram-negative bacteria. Neisseria meningitidis. There are several groups and sub-types of this organism. The bacteria are sensitive to sunlight and changes in temperature. They do not survive for 30 minutes. The disease usually occurs sporadically in the Philippines. Epidemics rarely occu

Alternative Names:Meningococcal septicemia; Meningococcal blood poisoning; Meningococcal bacteremia

Causes, incidence, and risk factors: Meningococcemia is caused by a bacteria called Neisseria meningitidis. The bacteria frequently lives in a person's upper respiratory tract without causing visible signs of illness. The bacteria can be spread from person to person through respiratory droplets -- for example, you may become infected if you are around someone with the condition when they sneeze or cough.

Family members and those closely exposed to someone with the condition are at increased risk. The infection occurs more frequently in winter and early spring. Symptoms: There may be few symptoms at first. Some may include:

Anxiety Fever Irritability Spotty red or purple rash (petechiae) Additional symptoms may include:

Headache Muscle and joint pain Nausea Vomiting Later symptoms may include:

Changing level of consciousness Ill appearance Large areas of bleeding under the skin (purpura)

Shock Sign and symptoms:

Meningococcemia is usually characterized by a sudden onset of fever, nausea, vomiting and frequently, a petechial rash which becomes bigger with reddish or purplish color located mainly on the extremities. The patient usually becomes prrogressively sicker. Meningitis with symptoms such as stiff neck, intense headache, back pain and mental status changes is the most common localized manifestation. Meningococcal infection may also be asymptomatic, or may produce only acute nasopharyngitis. Diagnostic tests Blood tests will be done to rule out other infections and help confirm meningococcemia. Such tests may include:

Blood culture Complete blood count with differential Clotting studies (PT, PTT) Other tests that may be done include:

Lumbar puncture to obtain spinal fluid sample for CSF culture Skin biopsy and gram stain Urinalysis Treatment

Persons with this type of infection are often admitted to the intensive care unit of the hospital, where they are closely monitored. The person may be placed in respiratory isolation for the first 24 hours to help prevent the spread of the infection to others. Treatments may include:

Antibiotics given through a vein (IV) Breathing support Clotting factors or platelet replacement -- if bleeding disorders develop Fluids through a vein (IV) Medications to treat blood pressure problems Wound care for areas of skin with blood clots

Complications

Arthritis Blood clotting that leads to the loss of the arms or legs Cutaneous vasculitis (inflammation of blood vessels in the skin) Disseminated intravascular coagulopathy (DIC) Irreversible shock Pericarditis Profound shock Waterhouse-Friderichsen syndrome

1. also effective. 2. How do we avoid getting sick of meningococcemia? Preventive antibiotic medication This is recommended only for the close contacts of meningococcal patients, because unnecessary and improper use of antibiotics can lead to emergence of drug resistant bacteria. Close contacts are people directly exposed to the respiratory secretions of infected people. These include: a) household members b) visitors who stayed overnight within 7 days before the illness of the case c) stayed in the same room with a case for 4 hours or more d)anyone directly exposed to the patients orals secretions.This is given as soon as possible after exposure to a diagnosed case as prescribed by the physician. Recommended medicines for prevention: rifampicin, ciprofloxacin, ceftriaxone, sulfadiazine. Health workers and other close contacts should wear personal protective devices like masks and rubber gloves. Wash hands with soap and water after attending to each patient. Properly dispose of articles soiled with discharges from the nose and throat of patients. Avoid sharing of eating or drinking utensils. Practice healthy lifestyle. Get enough rest and exercise, avoid smoking and eat wellbalanced diet which includes fruits and vegetables rich in vitamins to build up the immune system. Avoid crowded places to minimize exposure to the disease. 3. Do we need to undergo vaccination?

Vaccination is 85% to 95% protective. It starts to be protective after 5 days from theinjection. Protection lasts for 2.5 to 3 years. It is not protective to children below 2 years old. It is not a recommended public health measure but it may be taken as a personal protective measure

Meningococcemia
Definition Meningococcemia is an acute and potentially life-threatening infection of the bloodstream that commonly leads to inflammation of the blood vessels (vasculitis). See also: Septicemia Alternative Names Meningococcal septicemia; Meningococcal blood poisoning; Meningococcal bacteremia Causes Meningococcemia is caused by a bacteria called Neisseria meningitidis. The bacteria frequently lives in a person's upper respiratory tract without causing visible signs of illness. The bacteria can be spread from person to person through respiratory droplets -- for example, you may become infected if you are around someone with the condition when they sneeze or cough. Family members and those closely exposed to someone with the condition are at increased risk. The infection occurs more frequently in winter and early spring. Symptoms There may be few symptoms at first. Some may include:
Anxiety Fever Irritability

Spotty red or purple rash (petechiae) Additional symptoms may include:

Headache Muscle and joint pain

Nausea Vomiting

Later symptoms may include: Changing level of consciousness Ill appearance Large areas of bleeding under the skin (purpura) Shock Exams and Tests Blood tests will be done to rule out other infections and help confirm meningococcemia. Such tests may include:
Blood culture Complete blood count with differential Clotting studies (PT, PTT)

Other tests that may be done include:

Lumbar puncture to obtain spinal fluid sample for CSF culture Skin biopsy and gram stain Urinalysis Treatment

Persons with this type of infection are often admitted to the intensive care unit of the hospital, where they are closely monitored. The person may be placed in respiratory isolation for the first 24 hours to help prevent the spread of the infection to others. Treatments may include: Antibiotics given through a vein (IV) Breathing support Clotting factors or platelet replacement -- if bleeding disorders develop Fluids through a vein (IV) Medications to treat blood pressure problems Wound care for areas of skin with blood clots Outlook (Prognosis) Early treatment results in a good outcome. When shock develops, the outcome is less certain. The condition is most life threatening in those who have:

Disseminated intravascular coagulopathy (DIC) - a severe bleeding disorder Kidney failure Profound shock Patients who do not develop meningitis also tend to have a poorer outcome. Possible Complications

Arthritis Blood clotting that leads to the loss of the arms or legs Disseminated intravascular coagulopathy (DIC) Inflammation of blood vessels in the skin (cutaneous vasculitis) Irreversible shock Pericarditis Profound shock Severe damage to adrenal glands that can lead to low blood pressure (WaterhouseFriderichsen syndrome)

When to Contact a Medical Professional Go to the emergency room immediately if you have symptoms of meningococcemia. Call your doctor if you have been around someone with the disease. Prevention Preventive antibiotics for family members and contacts are often recommended. Speak with your health care provider about this option. A vaccine that covers some -- but not all -- strains of meningococcus is available, and has been suggested for use by college students who live in dormitories. You should discuss the appropriate use of this vaccine with your health care provider.

NCP Nursing Care Plans For Meningococcal Infections

NCP Nursing Care Plans For Meningococcal Infections. Two major meningococcalinfections, meningitis and meningococcemia, are caused by the gram-negative bacteria Neisseria meningitidis, which also causes primary pneumonia, purulent conjunctivitis, endocarditis, sinusitis, and genital infection. Meningococcemia occurs as simple bacteremia, fulminating meningococcemia and, rarely, chronic meningococcemia. It commonly accompanies meningitis. Meningococcalinfections may occur sporadically or in epidemics; particularly virulent infectionsmay be fatal within a matter of hours.

Causes For Meningococcal Infections Neisseria meningitidis has seven serogroups (A, B, C, D, X, Y, and Z

Complications For Meningococcal Infections

Respiratory failure that requires mechanical ventilation. If severe Disseminated intravascular coagulation (DIC) develops, Hemorrhage GI tract, and urinary tract, as well as tissue ischemia. Septic arthritis, pericarditis, or endophthalmitis. Aspiration of the organism can cause meningococcal pneumonia. Meningococcal infections may progress very rapidly, causing neurologic deterioration and even death.

Nursing Assessment Nursing Care Plans For Meningococcal Infections Features of meningococcal bacteremia include sudden spiking fever, headache, sore throat, cough, chills, myalgia , arthralgia, tachycardia, tachypnea, mild hypotension, and a petechial, nodular, or maculopapular rash. Headache and stiff neck can also occur as the infection extends to the meninges. Characteristics of the rare chronic meningococcemia include intermittent fever, rash, joint pain, and an enlarged spleen.

Diagnostic tests For Meningococcal Infections Blood culture, Cerebrospinal Fluid CSF culture

Nursing diagnosis Nursing Care Plans For Meningococcal Infections

Acute pain Hyperthermia Decreased cardiac output Impaired skin integrity Ineffective breathing pattern Ineffective tissue perfusion: Cardiopulmonary

Nursing outcomes Nursing Care Plans For Meningococcal Infections

The patient will express feelings of comfort and relief from pain. The patient will maintain adequate cardiac output. The patient will remain a febrile. The patient's skin will remain warm, dry, and intact. The patient will exhibit healed or improved lesions or wounds. The patient's ventilation will remain adequate. The patient will maintain collateral circulation. The patient will remain hemodynamically stable.

Nursing interventions Nursing Care Plans For Meningococcal Infections

Pain Management: Alleviation of pain or a reduction in pain to a level of comfort that is acceptable to the patient Analgesic Administration: Use of pharmacologic agents to reduce or eliminate pain Temperature Regulation: Attaining and/or maintaining body temperature within a normal range Fever Treatment: Management of a patient with hyperpyrexia caused by non environmental factors Malignant Hyperthermia Precautions: Prevention or reduction of hyper metabolic response to pharmacological agents

Hemodynamic Regulation: Optimization of heart rate, preload, after load, and contractility Cardiac Care: Limitation of complications resulting from an imbalance between myocardial oxygen supply and demand for a patient with symptomsof impaired cardiac function Skin Surveillance: Collection and analysis of patient data to maintain skinand mucous membrane integrity Pressure Management: Minimizing pressure to body parts Pressure Ulcer Prevention: Prevention of pressure ulcers for a patient at high risk for developing them Ventilation Assistance: Promotion of an optimal spontaneous breathingpattern that maximizes oxygen and carbon dioxide exchange in the lungs Airway Management: Facilitation of patency of air passages Respiratory Monitoring: Collection and analysis of patient data to ensure airway patency and adequate gas exchange Fluid/Electrolyte Management: Promotion of fluid/electrolyte balance and prevention of complications resulting from abnormal or undesired fluid/serum electrolyte levels Cerebral Perfusion Promotion: Promotion of adequate perfusion and limitation of complications for a patient experiencing or at risk for inadequate cerebral perfusion Cardiac Care: Limitation of complications resulting from an imbalance between myocardial oxygen supply and demand for a patient with symptomsof impaired cardiac function Gastrointestinal Intubation: Insertion of a tube into the gastrointestinal tract Circulatory Care: Arterial/Venous Insufficiency: Promotion of arterial/venous circulation