Diagnosis of meningococcal infection
- Michael Apicella, MD
Michael Apicella, MD
- Emeritus Professor of Microbiology and Internal Medicine
- The University of Iowa
- Section Editors
- Stephen B Calderwood, MD
Stephen B Calderwood, MD
- Editor-in-Chief — Infectious Diseases
- Section Editor — Bacterial Infections
- Professor of Medicine (Microbiology and Immunobiology)
- Harvard Medical School
- Morven S Edwards, MD
Morven S Edwards, MD
- Section Editor — Pediatric Infectious Diseases
- Professor of Pediatrics
- Baylor College of Medicine
Neisseria meningitidis is the second most common cause of community-acquired adult bacterial meningitis in the United States . Since routine vaccination of infants with the Haemophilus influenzae type b capsular conjugate vaccine was introduced, N. meningitidis has become the leading cause of bacterial meningitis in children and adolescents in the United States. (See "Bacterial meningitis in children older than one month: Clinical features and diagnosis", section on 'Causative organisms'.)
The clinical manifestations of meningococcal disease can be quite varied, ranging from transient fever and bacteremia to fulminant disease with death ensuing within hours of the onset of clinical symptoms. (See "Clinical manifestations of meningococcal infection".)
The diagnosis of meningococcal infection will be reviewed here [2-4]. The gold standard for the diagnosis of systemic meningococcal infection is the isolation of N. meningitidis from a usually sterile body fluid, such as blood or cerebrospinal fluid, or, less commonly, synovial, pleural, or pericardial fluid.
The microbiology, pathogenesis, epidemiology, treatment and prevention of N. meningitidis infection are discussed separately. (See "Microbiology and pathobiology of Neisseria meningitidis" and "Epidemiology of Neisseria meningitidis infection" and "Treatment and prevention of meningococcal infection".)
It is important to isolate the organism not only to confirm an etiology of infection but also to perform antibiotic susceptibility testing. Meningococci with increasing resistance to the penicillins, chloramphenicol, and cephalosporins have been reported [5-10].
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