Treatment and prevention 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 a common cause of community-acquired bacterial meningitis in children and adults in the United States and in many other countries. (See "Epidemiology of Neisseria meningitidis infection" and "Bacterial meningitis in children older than one month: Clinical features and diagnosis", section on 'Causative organisms' and "Epidemiology of bacterial meningitis in adults".)
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 treatment and prevention of meningococcal infection will be reviewed here [1-3]. The microbiology, pathobiology, epidemiology, and diagnosis of N. meningitidis infection are discussed separately. (See "Microbiology and pathobiology of Neisseria meningitidis" and "Epidemiology of Neisseria meningitidis infection" and "Diagnosis of meningococcal infection".)
Meningococcal meningitis and sepsis — Early and appropriate antibiotic treatment markedly improves the outcome of meningococcal infections. The current mortality rate of meningococcal sepsis in the United States is approximately 10 to 14 percent. The supportive data are presented below . (See 'Prognosis' below.)
Because of the importance of early antibiotic therapy, meningococcal infection should be considered in the differential diagnosis of any patient with the sudden onset of a febrile illness, especially those with petechiae and/or meningeal signs.
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- Meningococcal meningitis and sepsis
- - Antibiotic therapy
- Empiric therapy in nonepidemic settings
- Empiric treatment during epidemics
- Duration of therapy
- - Treatment of shock
- - Supportive care
- Protein C concentrate
- Treatment of complications
- - Purpura fulminans
- - Disseminated intravascular coagulation
- - Other life-threatening complications
- Treatment of genitourinary infection
- Droplet precautions
- Antimicrobial chemoprophylaxis
- - Close contacts
- - Timing of prophylaxis
- - Regimens
- - Nasopharyngeal carriage
- SUMMARY AND RECOMMENDATIONS