How does the infection progress?
Meningococcus is transmitted by airborne droplets through close and prolonged contact - in a family, hostel, or children's group. In most people it is limited to the nasopharynx and causes only mild nasopharyngitis or asymptomatic carriage. Only in a small proportion of infected people does the bacterium break into the blood. Then meningococcemia develops with damage to blood vessels, hemorrhages in the skin and a drop in pressure, or purulent meningitis with inflammation of the meninges, or a combination of both. It is the vascular lesion that explains the characteristic rash and severity of the condition.
- Carrier without symptoms
- Nasopharyngitis - mild form
- Meningococcemia - blood poisoning with rash
- Purulent meningitis
- Mixed form
- Transmission through close, prolonged contact
Early symptoms and rash
The disease often begins as a viral infection: the temperature rises sharply, weakness, muscle pain, headache, and vomiting appear. Paleness, cold hands and feet at high temperatures, unusual lethargy and pain in the legs should be alarming. The rash appears after a few hours and may initially appear as isolated pink spots, but quickly becomes dark purple, star-shaped, with a thickening in the center. A simple test: if you press a transparent glass against the rash, the elements do not turn pale. With meningitis, photophobia, the inability to tilt the head forward and increasing drowsiness are added.
- Sudden high fever
- Headache, vomiting, muscle and leg pain
- Pale, cold hands and feet
- Dark, star-shaped rash that does not fade when pressed
- Photophobia and stiff neck
- In infants - bulging fontanel, monotonous cry
- Rapid increase in symptoms
Diagnostics
The diagnosis begins to be treated earlier than it is confirmed: in case of a characteristic rash and severe condition, an antibiotic is administered immediately. In the hospital, blood is taken for culture, a complete blood count, C-reactive protein, procalcitonin, coagulogram are performed, kidney function and electrolytes are assessed. Lumbar puncture allows you to examine the cerebrospinal fluid and confirm purulent meningitis, but it is not performed on everyone and not always right away - in unstable conditions and signs of cerebral edema, it is postponed. Close contacts are also examined.
- Immediate initiation of treatment with a characteristic picture
- Blood cultures before starting antibiotics unless this delays treatment
- Complete blood count, C-reactive protein, procalcitonin
- Coagulogram, electrolytes, creatinine
- Lumbar puncture according to indications
- Examination of contact persons
Treatment
Treatment is carried out in a hospital, in severe forms - in the intensive care unit. Antibiotics are administered intravenously as early as possible, sometimes already at the emergency stage. At the same time, they are fighting against a drop in blood pressure and blood clotting disorders: they administer solutions, support the functioning of the heart and kidneys, and control breathing. In case of meningitis, monitor intracranial pressure and manifestations of cerebral edema. Home treatment and waiting for the effect of antipyretic drugs is unacceptable: with this infection, hours matter. Even with successful treatment, follow-up is necessary, as hearing and nervous system effects are possible.
- Emergency hospitalization
- Intravenous antibiotics as early as possible
- Fluid therapy and circulatory support
- Treatment of bleeding disorders
- Control of intracranial pressure during meningitis
- Observation by a neurologist and hearing test after recovery
Prevention and contact with the sick
There are vaccines against the main groups of meningococcus, and they are included in the immunization programs of many countries, and in a number of situations they are recommended separately: for young children, adolescents, people without a spleen, with some immune disorders, pilgrims and when traveling to regions with high incidence. The question of vaccination is decided by the doctor. Those who have been in close contact with the sick person—family members, roommates—are prescribed a prophylactic antibiotic to remove the bacteria from the nasopharynx. General measures include ventilation, avoiding sharing utensils and bottles, and limiting close contact during outbreaks.
- Vaccination as recommended by a doctor
- Prophylactic antibiotic for close contacts
- Separate utensils, no shared bottle drinking
- Ventilation and reduction of crowding
- Contact your contact immediately at the first sign
- Special attention to people without a spleen