Meningococcemia Questions & Answers

Updated: Aug 13, 2019
  • Author: Mahmud H Javid, MBBS; Chief Editor: John L Brusch, MD, FACP  more...
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Questions & Answers

Overview

What is meningococcemia?

What are the signs and symptoms of acute meningococcemia?

What are the signs and symptoms of meningitis in meningococcemia?

What are the signs and symptoms of meningococcemia?

What are the physical findings characteristic of meningococcemia?

What is the role of lab testing in the diagnosis of meningococcemia?

Which organizations have released treatment guidelines for meningococcemia?

When should patients with a meningococcemia rash be treated?

Which antibiotics are recommended in the treatment of meningococcemia?

What is N meningitidis?

What are the possible presentations of acute meningococcemia?

What are the carrier rates for N meningitidis?

What is chronic meningococcemia?

What is the pathophysiology of meningococcemia?

What is the clinical progression of meningococcemia?

What are the manifestations of fulminant meningococcemia?

What are the virulence factors associated with meningococcemia?

What is the pathophysiology of septicemia in meningococcemia?

What is the role of vascular permeability in the pathophysiology of meningococcemia?

What is the role of coagulopathy in the pathophysiology of meningococcemia?

Which metabolic derangements may occur in meningococcemia?

What causes myocardial failure in patients with meningococcemia?

What is the pathophysiology of meningitis in meningococcemia?

What causes meningococcemia?

How is meningococcemia transmitted?

How is immunity against meningococcemia acquired?

What is the role of terminal complement deficiency in the etiology of meningococcemia?

Which genetic factors increase the risk for mortality from meningococcemia?

Which risks are increased in patients with meningococcemia and the prothrombotic factor V Leiden mutation?

What is the role of the PAI-1 gene in the etiology of meningococcemia?

What are the risk factors for meningococcemia?

What is the incidence of meningococcemia in the US?

What is the global incidence of meningococcemia?

What is the incidence of meningococcemia in Europe and the United Kingdom?

How does climate-affect the incidence of meningococcemia?

What are the racial predilections for meningococcemia?

How does the prevalence of meningococcemia vary by sex?

How does the incidence of meningococcemia vary by age?

What is the prognosis of meningococcemia?

What are possible complications of meningococcemia?

What is the prevalence of immune complex disease due to meningococcal infection?

What are the complications of meningococcal meningitis?

What are the suppurative complications of meningococcemia?

What is the prevalence of nonsuppurative arthritis in meningococcemia?

What are possible complications of recurrent meningococcal disease?

What are the sequelae associated with meningococcemia?

What is the mortality rate for meningococcemia?

What information about meningococcemia should patients receive?

Presentation

Which history associated with is characteristic of meningococcemia?

What are the signs and symptoms of meningitis in meningococcemia?

What are the signs and symptoms of septicemia in meningococcemia?

Which history findings suggest chronic meningococcemia?

Which physical findings are characteristic of meningococcemia?

What are the dermatologic manifestations of meningococcemia?

Which physical findings are characteristic of fulminant meningococcemia?

Which physical findings are characteristic of meningococcal septicemia?

Which physical findings are characteristic of meningitis in meningococcemia?

DDX

Which conditions should be included in the cutaneous differential diagnoses of meningococcemia?

Which conditions should be included in the differential diagnoses of chromic meningococcemia?

How are rheumatic diseases differentiated from meningococcemia?

Which conditions should be included in the differential diagnoses of meningococcemia when petechiae and fever are present?

Which conditions should be included in the differential diagnoses of meningococcal infection?

What are the differential diagnoses for Meningococcemia?

Workup

What is the role of lab testing in the diagnosis of meningococcemia?

Which factors increase the risk for mortality in fulminant meningococcemia?

What is the role of blood cultures in the workup of meningococcemia?

What is the role of throat cultures in the workup of meningococcemia?

How is chronic meningococcemia diagnosed?

What is the role of imaging studies in the workup of meningococcemia?

When is blood culture indicated in the workup of meningococcemia?

What does a gram stain reveal in the workup of fulminant meningococcemia?

How is a rapid latex antigen test used in the workup of meningococcemia?

What is the role of coagulation tests in the workup of meningococcemia?

What is the role of white blood cell count in the workup of meningococcemia?

Which metabolic abnormalities may be present in meningococcemia?

How is end-organ damage assessed in the workup of meningococcemia?

What is the role of needle aspirations and skin biopsies in the workup of meningococcemia?

Which findings of biopsy specimens are characteristic of acute meningococcemia?

What are the indications of cutaneous petechiae and purpura in the histology of meningococcemia?

Which histologic findings are characteristic of chronic meningococcemia?

What is the role of polymerase chain reaction (PCR) assay in the workup of meningococcemia?

What is the role of a slide agglutination test use in the workup of meningococcemia?

What is the role of enzyme-linked immunosorbent assay (ELISA) in the workup of meningococcemia?

When are brain imaging studies indicated in the workup of meningococcemia?

What is the role of lumbar puncture in the workup of meningococcemia?

When is a lumbar puncture contraindicated in the workup of meningococcemia?

Treatment

What is the initial treatment of suspected meningococcemia?

What is included in the medical management septicemia and meningitis in meningococcemia?

Who should receive chemoprophylaxis and vaccination against meningococcal infection?

How is meningococcemia managed in adults?

What are the complications of meningococcemia and how are they managed?

What is included in the inpatient care for meningococcemia?

Which dietary modifications are used in the treatment of meningococcemia?

Which activity modifications are used in the treatment of meningococcemia?

When is transfer indicated for the treatment of meningococcemia?

Which organizations have published treatment guidelines for meningococcemia?

What is included in the initial treatment of meningococcemia symptoms?

What are the indications for intensive care in meningococcemia?

What is the treatment algorithm for emergency management of meningococcemia?

What is included in basic life support for meningococcemia?

What are the indications of shock in meningococcemia?

What is the initial therapy for shock in meningococcemia?

What is the treatment of meningococcemia in patients who do not respond to initial volume replacement?

When are endotracheal intubation and ventilation indicated in the treatment of meningococcemia?

When should additional fluid replacement be administered in the treatment of meningococcemia?

What corrections are required in the management of shock in meningococcemia?

What are the indications of increased intracranial pressure (ICP) in meningococcemia?

How is intracranial pressure (ICP) managed in patients with meningococcemia?

What is included in the treatment of meningococcemia in patients with limited shock and no increased intracranial pressure (ICP)?

What is the role of antibiotics in the treatment of meningococcemia?

What is the role of cephalosporins in the treatment of meningococcemia?

Which medications are ineffective in the treatment of meningococcemia?

What is included in intensive supportive care for fulminant meningococcemia?

What is the role of empiric therapy in the treatment of meningococcemia?

Which antibiotic should be administered prior to culture results for meningococcemia?

When should agents against H influenzae type B be included in empiric therapy for meningococcemia?

What is the empiric antibiotic therapy for meningitis in meningococcemia?

What is the role of ceftriaxone in the empiric therapy for meningococcemia?

What is the role of dexamethasone in the empiric therapy for meningococcemia?

What is the role of surgery in the treatment of meningococcemia?

What are the signs of pericarditis in meningococcemia?

Which skeletal deformities may occur in meningococcemia?

What is included in monitoring for late neurologic sequelae of meningococcemia?

What is included in the follow-up care of meningococcemia?

What is the increased risk of Guillain-Barré Syndrome (GBS) from the MCV4 meningococcal vaccine?

What type of vaccines are used to prevent meningococcemia?

What is the effectiveness of purified polysaccharide vaccines against meningococcemia?

What are the guidelines on meningococcal B vaccination by the Advisory Committee on Immunization Practices (ACIP)?

What are the types of vaccines are available against meningococcemia?

What are the ACIP expanded recommendations for the MenACWY-CRM vaccine to prevent meningococcemia?

What is the role of serogroup B vaccines in the prevention of meningococcemia?

What is the efficacy of serogroup B vaccines against meningococcemia?

What is the safety of the meningococcal polysaccharide vaccine in pregnant women?

How are secondary cases of sporadic meningococcal disease prevented?

How is chemoprophylaxis used in the prevention of meningococcemia?

What are the infection risks for secondary cases of meningococcemia?

What are the American Academy of Pediatrics (AAP) recommendations for antimicrobial chemoprophylaxis to prevent secondary cases of meningococcemia?

What is the role of public health authorities in the prevention of secondary meningococcemia?

When is antimicrobial chemoprophylaxis against meningococcemia indicated for hospital personnel?

When is antimicrobial chemoprophylaxis against meningococcemia indicated for travelers?

What is the role of rifampin in the management of meningococcemia?

What is the role of ciprofloxacin in the management of meningococcemia?

What is the role of ceftriaxone in the management of meningococcemia?

What is the role of sulfadiazine in the management of meningococcemia?

How is meningococcemia prevented?

Which specialist consultations are needed in the management of meningococcemia?

Guidelines

What are the ACIP guidelines on meningococcal B vaccination?

Medications

What is the focus of antimicrobial therapy for meningococcemia?

Which drugs are effective in treating active meningococcal infection?

What is the duration of antimicrobial treatment for meningococcemia?

Which individuals are at increased risk for meningococcemia?

How are rifampin and ciprofloxacin used in the management of meningococcemia?

What is the role of chloramphenicol in the treatment of meningococcemia?

Which medications in the drug class Vaccines, Inactivated, Bacterial are used in the treatment of Meningococcemia?

Which medications in the drug class Corticosteroids are used in the treatment of Meningococcemia?

Which medications in the drug class Diuretics, Loop are used in the treatment of Meningococcemia?

Which medications in the drug class Diuretics, Osmotic Agents are used in the treatment of Meningococcemia?

Which medications in the drug class Inotropic Agents are used in the treatment of Meningococcemia?

Which medications in the drug class Antimicrobial agents are used in the treatment of Meningococcemia?