Meningococcal septicaemia

Meningococcal disease
Charlotte Cleverley-Bisman, one of the youngest survivors of the disease. The infected arms had to be amputated later.
Classification and external resources
Specialty	Infectious disease, critical care medicine
ICD-10	A39
ICD-9-CM	036.9
DiseasesDB	8847
MedlinePlus	000608 meningitis. 001349 meningococcemia
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Meningococcal septicaemia
Classification and external resources
Specialty	infectious disease
ICD-10	A39.2-4
ICD-9-CM	036.2
MedlinePlus	001349
[]

Meningococcal disease describes infections caused by the bacterium Neisseria meningitidis (also termed meningococcus). It carries a high mortality rate if untreated but is a vaccine-preventable disease. While best known as a cause of meningitis, widespread blood infection can result in sepsis, which is a more damaging and dangerous condition. Meningitis and meningococcemia are major causes of illness, death, and disability in both developed and under-developed countries.

There are approximately 2,600 cases of bacterial meningitis per year in the United States, and on average 333,000 cases in developing countries. The case fatality rate ranges between 10 and 20 percent. The incidence of endemic meningococcal disease during the last 13 years ranges from 1 to 5 per 100,000 in developed countries, and from 10 to 25 per 100,000 in developing countries. During epidemics the incidence of meningococcal disease approaches 100 per 100,000. Meningococcal vaccines have sharply reduced the incidence of the disease in developed countries.

The disease's pathogenesis is not fully understood. The pathogen colonises a large number of the general population harmlessly, but in some very small percentage of individuals it can invade the blood stream, and the entire body but most notably limbs and brain, causing serious illness. Over the past few years, experts have made an intensive effort to understand specific aspects of meningococcal biology and host interactions, however the development of improved treatments and effective vaccines is expected to depend on novel efforts by workers in many different fields.

While meningococcal disease is not as contagious as the common cold (which is spread through casual contact), it can be transmitted through saliva and occasionally through close, prolonged general contact with an infected person.

Meningococcemia, like many other gram-negative blood infections, can cause disseminated intravascular coagulation (DIC), which is the inappropriate clotting of blood within the vessels. DIC can cause ischemic tissue damage when upstream thrombi obstruct blood flow and haemorrhage because clotting factors are exhausted. Small bleeds into the skin cause the characteristic petechial rash, which appears with a star-like shape. This is due to the release of toxins into the blood that break down the walls of blood vessels. A rash can develop under the skin due to blood leakage that may leave red or brownish pinprick spots, which can develop into purple bruising. Meningococcal rash can usually be confirmed by a glass test in which the rash does not fade away under pressure.

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Wikipedia