1/51. Acute abdomen as an atypical presentation of meningococcal septicaemia.The clinical manifestations and course of meningococcal disease have been well described, but atypical presentations may, if unrecognized, lead to a delay in treatment. We describe here an unusual case of this disease in a 21-y-old woman who presented with an acute rigid abdomen, clinical and laboratory features of sepsis, shock and early DIC with no indication of meningococcal infection. She developed a rapidly spreading purpuric rash, conjunctival haemorrhages, hypotension and tachycardia and a low urine output. Laboratory investigations showed a low platelet count, low haemoglobin and normal WBC. A presumptive diagnosis of meningococcal septicaemia was made and recovery followed treatment with cefotaxime, fluids and inotropes. A fully sensitive Neisseria meningitis Group C, type 2a, subtype NT was isolated from blood cultures, but not from CSF obtained after antibiotic treatment.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
2/51. Meningococcal disease and meningitis: a review of deaths proceeding to coroner directed autopsy in Auckland.AIMS: To assist the early diagnosis of meningitis, by finding trends and patient profiles, where delay or other factors may have lead to a fatal outcome. methods: All deaths from meningitis and meningococcal disease, confirmed at autopsy were reviewed. The study involved the Auckland area, in the period January 1988 November 1997. RESULTS: Cases were divided into those caused by N meningitidis and other meningitides. Death due to N meningitidis is often within 12-24 hours of the first symptomatology. Symptoms are often vague and may be indistinguishable from any other infection, often leading to fatal patient or doctor delay. A diagnosis of meningococcal disease cannot be excluded on: no rash (44%), no "meningitis" symptoms as sepsis without meningitis occurs (44%), age (50% were over 15 years old) or the presence of other abnormalities, eg bronchopneumonia or hydrocephalus. Non-N meningitidis menigitis is a disease of the very young or old, its time course is also swift with 30% suffering similar vague symptoms for less than 24 hours before death. CONCLUSIONS: For both categories, treat immediately and treat on suspicion, otherwise conformation of the diagnosis might be postmortem.- - - - - - - - - - ranking = 8keywords = meningitis (Clic here for more details about this article) |
3/51. Isolation of meningococci in meningococcal endophthalmitis.We describe a case of bilateral hypopyon in a 7-year-old African male receiving systemic antibiotic therapy for meningococcal meningitis. Aqueous from paracentesis of the left eye contained intra- and extra-cellular Gram negative diplococci. We believe this is the first report of isolation of the organism since the advent of antibiotic treatment.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
4/51. Seven-week interval between acquisition of a meningococcus and the onset of invasive disease. A case report.Invasive meningococcal disease (IMD) is thought to occur within a few days of pharyngeal acquisition of neisseria meningitidis. During a longitudinal study of carriage and acquisition among 2453 first-year undergraduates we identified a male student from whom N. lactamica was isolated in October 1997 followed by N. meningitidis in December 1997. In mid-January 1998 this student suffered a mild episode of IMD (meningitis) during which N. meningitidis was isolated from his CSF. The meningococcus carried in December 1997 was phenotypically and genotypically indistinguishable from the invading organism, suggesting the possibility that the organism may have been carried for 7 weeks prior to the onset of invasive disease. Further studies are needed to assess more accurately the range of asymptomatic carriage prior to disease onset.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
5/51. purpura fulminans in children: report of two cases.purpura fulminans, usually seen in previously healthy children acquiring severe infections, especially meningococcal sepsis and meningitis, is a rare catastrophic disease with initial hemorrhagic skin lesions rapidly progressing to gangrene accompanied by shock and frequently resulting in death. We report 2 cases of purpura fulminans who were diagnosed in the past 2 years. Both blood cultures yielded neisseria meningitidis. One of them expired within 48 hours after admission despite aggressive therapy. The second patient, who received the treatment of heparin, antibiotics, and blood product replacement, survived with minimal sequelae. We deem young age and severe coagulopathy are especially associated with a fatal outcome in children with purpura fulminans. Early recognition of this disease and prompt appropriate therapy may be lifesaving for these patients.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
6/51. Management and prevention of meningococcal disease.While many other illnesses affecting children have been contained or even eliminated, meningococcal disease has become a leading infectious cause of death. The major management challenge may be increased intracranial pressure or toxic shock, depending on whether meningitis or septicemia predominates. A new protein-conjugated group C vaccine is expected to reduce deaths by as much as 40%.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
7/51. Meningococcal septicemia post adenotonsillectomy in a child: case report.hemorrhage, nausea and vomiting and poor oral intake remain the most commonly encountered complications after adenotonsillectomy in the pediatric population. life-threatening infectious complications such as meningitis have rarely been reported. We report a case of meningococcal septicemia complicating adenotonsillectomy in a 3-year-old male child. Possible etiologies postulated include: septicemia following transient bacteremia, increased meningococcal carrier rate, transient immune deficiency, and mucosal damage promoting bacterial translocation. This case highlights the responsibility of the otolaryngologist to maintain medical review, especially when recovery following TA is slow.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
8/51. Exposure to patients with meningococcal disease on aircrafts--united states, 1999-2001.neisseria meningitidis is a leading cause of bacterial meningitis and sepsis in children and young adults in the united states and is spread through direct contact with respiratory secretions. persons in close contact with patients who have meningococcal disease are at increased risk for contracting the disease. Commercial aircraft are suitable environments for the spread of airborne pathogens, including N. meningitidis. A case of air-travel-associated meningococcal disease is defined as a patient who meets the case definition of meningococcal disease within 14 days of travel on a flight of at least 8 hours duration. Because of concerns about disease transmission aboard aircraft, CDC has developed recommendations to ensure a standard approach to management of airline contacts. This report presents a case of air-travel-associated meningococcal disease and presents guidelines for the management of persons potentially exposed to meningococcus during airtravel.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
9/51. Primary meningococcal arthritis in a prosthetic knee joint.neisseria meningitidis is known to cause a spectrum of diseases, including bacteraemia without sepsis, meningococcaemia without meningitis, meningitis with or without meningococcaemia, and chronic meningococcaemia. Less common manifestations of meningococcal infection include pharyngitis, pneumonia, pericarditis, urethritis and arthritis. To our knowledge, there have been no previous reports of N. meningitidis causing prosthetic joint infection. Herein, we report a case of primary meningococcal arthritis in a woman with a prosthetic knee joint. After surgical drainage the prosthesis was retained and the patient received appropriate and prolonged antibiotic treatment. The outcome was favourable, as with primary meningococcal arthritis affecting native joints.- - - - - - - - - - ranking = 2keywords = meningitis (Clic here for more details about this article) |
10/51. meningococcal infections and meningitis: what is new?Meningococcal infection is one of the very few severe bacterial infections, in this era, that still can kill a relatively healthy child within minutes. Fortunately, it is a relatively rare disease. Rural practitioners may see one affected child once every 2-3 years, but once seen they will never forget it. The present article gives some examples of case scenarios along with a brief overview of the problem, with emphasis on early diagnosis, prevention and possible future developments.- - - - - - - - - - ranking = 4keywords = meningitis (Clic here for more details about this article) |
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