Meningococcal infection: symptoms and treatment


Meningococcal infection provokes anthroponous diseases — meningitis, meningococcal sepsis with fulminant course. Practically 80% of all clinical cases occur in children. Clinicians note that the peak of the disease occurs during the warm season, but cases of damage are diagnosed throughout the year.

Etiology

The etiology of this pathological process has been well studied. The causative agent of the disease is gram-negative diplococcus. It should be noted that this virus is practically not resistant to the external environment. He perishes from a difference in temperature, humidity, under the influence of sunlight. Outside the living organism, the virus dies after 30 minutes.

Ways of infection

The carrier of the disease is only the already infected person. The virus is transmitted exclusively by airborne droplets. The greatest danger is represented by patients with affected respiratory tract.

It should be noted that the lethality in the disease with this disease is the highest. Immunity to meningococcal infection is not present. It is not uncommon for cases when the ill child was repeatedly infected with the given disease in 2-3 years.

Pathogenesis

With favorable conditions for infection, getting on the mucous membrane in the nasopharynx, the virus begins to multiply. Depending on the reactivity of the organism and the age of the patient, this process has a different duration.

Then the infection can get into the bloodstream. In this case, meningococcal sepsis begins — the disintegration of meningococci is observed and the production of endotoxin begins. Thus, a strong vascular poison is produced. In turn, this leads to hemorrhages in the skin and internal organs.

The infection can also damage the soft shell of the brain, which leads to encephalitis.

General Symptoms

The incubation period of this infectious process is from 2 to 10 days. At the initial stage of development of meningococcal infection in the clinical picture practically does not differ from ARI. This factor greatly complicates the diagnosis and further treatment. If you diagnose the disease at an early stage, complications can be avoided.

As the pathological process develops, at the initial stage, it is possible to observe such symptoms of meningococcal infection:


  • body temperature ranges from elevated (up to 38 degrees) to low (less than 36)
  • headache;
  • weakness, drowsiness;
  • a runny nose, sometimes just a stuffy nose.

This condition of the patient can be observed for about three days. Then you can observe such signs of meningococcal infection:


  1. After a brief stabilization of health, the temperature will rise sharply to 39 degrees;
  2. the patient is suffering from chills, fever
  3. pain in muscular structures and articular joints
  4. sudden mood swings;
  5. nausea and vomiting
  6. almost total lack of appetite.

Meningococcal infection in children is almost the same. However, it should be noted that the rash with meningococcal infection in them is observed much more often than in adults. Hemorrhagic rash, as a rule, manifests itself on the first-second days after the first symptoms manifest.

It is the manifestation of the rash that indicates an extremely unfavorable prognosis of meningococcal infection. Quite often such signs are understood as an allergic reaction against antibiotics or other medications.

As a rule, the rash is located throughout the body and limbs chaotically. The spots do not have clear contours, light pink in color. Gradually the bright color disappears, in the center of the spots necrosis is formed. Often spots at this stage can merge. At the final stage, the necrosis turns into dry gangrene. More often, the pathological process concerns the fingertips, the auricles and the nose. In more complex clinical cases, the rash can form even on the eyelids and face.

Such signs of infection indicate a very negative outlook. In most cases, meningococcal infection in such a clinical picture leads to a fatal outcome. Especially when it comes to children under three years old.

Clinicians note that in the most difficult clinical cases, the patient may have a hemorrhage in the eye mucosa, internal bleeding of the kidneys and stomach may open.

Classification

In the form of development of meningococcal infection, the following types are distinguished:


  • meningococcal sepsis
  • meningitis
  • meningococcal nasopharyngitis

According to the nature of the development of the disease, the following forms are distinguished:


  1. localized
  2. generalized
  3. rare.

The following diseases can be attributed to the last character of development of the pathological process:


  • meningococcal synovitis
  • meningococcal endocarditis;
  • meningococcal pneumonia
  • meningococcal iridocyclitis

This development of the disease is extremely rare.

Meningococcal nasopharyngitis

This form of meningococcal infection manifests itself in the form of the following symptoms:


  1. a slight increase in body temperature (up to 38 degrees)
  2. nasal congestion
  3. dryness of the nasopharyngeal mucosa
  4. pain when swallowing
  5. weakness;
  6. runny nose with scanty mucous discharge.

Since the clinical picture almost completely indicates a common cold, in most cases the patient does not seek medical help in time, which almost always leads to serious complications or death.

Set the exact diagnosis, in this case, can only be done after bacteriological studies.

Meningitis

One of the most common forms of meningococcal infection. In this case, there is almost no restriction on age or gender. However, in case of infection of the infant organism, the lethal outcome is most often observed.

Meningitis can be either an independent disease or part of a generalized process. Symptomatics, in this case, is as follows:






  • the body temperature rises sharply
  • nausea and vomiting
  • severe headache, which does not decrease even under the influence of an anesthetic
  • increased sensitivity to light and sound stimuli
  • cramps;
  • change of consciousness
  • GI disorder.

Meningococcal infection in children is supplemented by such signs:


  1. almost complete refusal to eat, constant thirst
  2. the child is always lying on his side, throwing his head back.

Clinicians note that in some cases the patient has an enlarged liver and spleen. Against the background of such a clinical picture, blood pressure is greatly reduced, the tone of the heart becomes very weak and muffled.

Meningococcal sepsis

In some cases, this form of infection may be accompanied by a clinical picture of meningitis, but not always. The most common symptom is a rash. Gradually, necrosis and dry gangrene are formed.

If treatment is not started in time, the lethal outcome is almost always diagnosed. The clinical picture can be observed from 2 weeks to 2 months. The death of a patient can occur at any stage of the development of the pathological process. In some cases, it is possible to improve the patient’s condition, but for a short time.

With adequate and timely treatment, the patient’s condition can improve after 6-12 hours. Full recovery is possible in 2-3 weeks, provided that the therapy is correct.

Diagnostics

Early diagnosis when suspected of this infection almost completely guarantees recovery. However, completely avoid complications, with this type of ailment, it is almost impossible.

At the first manifestations of the above clinical picture, you should immediately seek medical help. After a personal examination and clarification of the anamnesis, diagnostics is carried out using laboratory and instrumental methods of research.

The standard diagnostic program includes the following:


  • bacteriological examination of blood, mucus from the nasopharynx, liquor
  • bacterioscopy of blood and liquor (express method)
  • Lumbar puncture
  • serological studies

If on the basis of the above clinical analysis, an exact diagnosis could not be made, differential diagnosis is performed. If there is a rash on it, you should pay special attention. At the initial stage of the manifestation of the rash is similar to an allergic reaction or measles. However, it should be noted that the rash in meningococcal infection is rapidly replaced by necrosis and dry gangrene, which is not the case with allergies.

It is possible to accurately diagnose and prescribe the correct treatment against this ailment only on the basis of the results of the diagnosis. It should also be understood that in some cases, a full program of tests may not be available. The earlier a person seeks medical help, the greater the chance of a full recovery.

Treatment

First of all, medical events are directed against the focus of the infection and on the elimination of the pathogen. However, it should be noted that not always the state of health of the patient makes it possible to carry out such therapeutic measures.

First of all, the patient is hospitalized in a medical institution. If the patient is not sent immediately to the profile hospital, it can only be translated after the patient’s condition has improved or stabilized. Clinical measures against the virus are carried out with the help of etiotropic drugs.

The treatment program includes the following measures directed against meningococcal infection:


  1. antibacterial therapy
  2. saline infusion therapy
  3. anti-seizure drugs
  4. glucocorticosteroids;
  5. detoxification therapy
  6. preparations of the syndromic spectrum of action.

It should be noted that if the family of the patient has children of younger preschool age or employees of children’s institutions, a vaccination against meningococcal infection is mandatory. Vaccination against infection should be carried out as prevention.

Treatment of meningococcal infection is possible only on an outpatient basis if a localized form of infection is diagnosed. In all other cases, treatment is mandatory only permanently, according to the protocol of the Ministry of Health.

The patient can be discharged only after the rates of CSF and blood are normal. A swab from the nasopharynx is taken only after three days after antibacterial treatment.

Possible complications

The arrival of a late patient is considered to be after the expiration of the day after the first manifestation of the clinical picture. In this case, the clinical measures against the removal of the focus of the infection may not give the proper result. No exception is lethal.

It should also be noted such possible complications after meningococcal infection:


  • damage to the auditory nerve
  • paralysis
  • Brain abscess;
  • violation of the CNS;
  • mental disorders.

No exception and secondary infection if vaccination is not performed.

Prevention

If a family or an institution is diagnosed with the disease, it is necessary to report this to the Sanitary and Epidemiological Station. They will carry out the necessary preventive measures. If the infection was detected in a children’s institution, quarantine is established as a preventive measure for at least 10 days. Vaccination is mandatory.

As for general prevention, in this case, there is practically no possibility to completely exclude the development of infection. To date, vaccination is the most effective measure of prevention.