XI.

SURGICAL MANAGEMENT

Because mortality may be reduced with early antibiotic therapy, patients with a

meningococcal rash should receive parenteral antibiotics by means of an intravenous (IV)

or intramuscular (IM) route as soon as the diagnosis is suspected. In the United Kingdom,

prehospital treatment with benzylpenicillin is recommended.

Intramuscular antibiotic injections may be less effective in a patient with shock and

poor tissue perfusion.

Tests can confirm a diagnosis of meningococcal meningitis. The doctor may start

antibiotics, such as penicillin or ceftriaxone, by an IV, or intravenous line. You or your

child may also need other medication to treat problems related to increased spinal fluid

pressure. Doctors sometimes prescribe steroids.

Meningococcal meningitis is a serious disease -- even with treatment. That's why

prevention is a far better approach. The meningococcal vaccinecan prevent meningitis

infection. In the U.S., three types of meningococcal vaccines are used:

Meningococcal conjugate vaccine (MCV4)-- One of these vaccines, Menactra, is

approved for people ages 9 months to 55. The other, Menveo, is used in those ages 2

through 55.Meningococcal polysaccharide vaccine (MPSV4) -- This vaccine was approved

in the 1970s and protects against most forms of meningococcal disease. This vaccine used

is for people as young as 9 months and older than age 55.Serogroup B Meningococcal B -

There are two MenB vaccines. Trumenba (MenB-FHbp) and Bexsero (MenB-4C). Both

are licensed for ages 10-24 but can be used in older patients.

Doctors recommend a dose of MCV4, which is given as a shot, for children at age

11, and then a booster shot at age 16. If the first dose is missed, the MCV4 can be

administered between ages 13 and 15, followed by a booster dose between ages 16 and 18.

The Serogroup B Meningococcal B vaccine is recommended for ages 16 to 18.