Meningococcemia Health Article

Definition

Meningococcemia is the presence of meningococcus in the bloodstream. Meningococcus, a bacteria formally called Neisseria meningitidis, can be one of the most dramatic and rapidly fatal of all infectious diseases.

Causes and symptoms

Meningococcemia, a relatively uncommon infection, occurs most commonly in children and young adults. In susceptible people, it may cause a very severe illness that can produce death within hours. The bacteria, which can spread from person to person, usually first causes a colonization in the upper airway, but without symptoms. From there, it can penetrate into the bloodstream to the central nervous system and cause meningitis or develop into a full-blown bloodstream infection (meningococcemia). Fortunately in most colonized people, this does not happen and the result of this colonization is long-lasting immunity against the particular strain.

After colonization is established, symptoms can develop within one day to one to two weeks. After a short period of time (one hour up to one to two days) when the patient complains of fever and muscle aches, more severe symptoms can develop. Unfortunately during this early stage, a doctor cannot tell this illness from any other illness, such as a viral infection like influenza. Unless the case is occurring in a person known to have been exposed to or in the midst of an epidemic of meningococcal disease, there may be no specific symptoms or signs found that help the doctor diagnose the problem. Rarely, a low-grade bloodstream infection called chronic meningococcemia can occur.

After this initial period, the patient will often complain of continued fever, shaking chills, overwhelming weakness, and even a feeling of impending doom. The organism is multiplying in the bloodstream, unchecked by the immune system. The severity of the illness and its dire complications are caused by the damage the organism does to the small blood vessel walls. This damage is called a vasculitis, an inflammation of a blood vessel. Damage to the small vessels causes them to become leaky. The first signs of the infection's severity are small bleeding spots seen on the skin (petechiae). A doctor should always suspect meningococcemia when he/she finds an acutely ill patient with fever, chills, and petechiae.

Quickly (within hours), the blood vessel damage increases and large bleeding areas on the skin (purpura) are seen. The same changes are taking place in the affected person's internal organs. The blood pressure is often low and there may be signs of bleeding from other organs (like coughing up blood, nose bleeds, blood in the urine). The organism not only damages the blood vessels by causing them to leak, but also causes clotting inside the vessels. If this clotting occurs in the larger arteries, it results in major tissue damage. Essentially, large areas of skin, muscle, and internal organs die from lack of blood and oxygen. Even if the disease is quickly diagnosed and treated, the patient has a high risk of dying.