Meningococcal Sepsis - A Serious Disease

22 September, 2020
Meningococcal sepsis is a serious condition caused by the spread of meningococci in the bloodstream and various organs. It results in the formation of thrombi that can lead to gangrene and other complications.

Meningococcal sepsis is a medical emergency and requires immediate treatment. It’s a rapidly progressing disease that can lead to shock and the simultaneous failure of several organs in the body.

This condition stems from a meningococcal infection. The World Health Organization (WHO) estimates there are around 500,000 new such infections per year. In fact, between 20 and 50% of those who develop meningococcal sepsis die.

Meningococcal disease

This condition is due to meningococcus, a bacterium that causes serious diseases. Anyone can acquire it after contact with the droplets an infected person expels when coughing or sneezing.

Some individuals are highly sensitive to these bacteria, but science doesn’t know why. What we do know is this microorganism progressively invades the nasopharynx. Furthermore, the interval between infection and the appearance of symptoms is about 10 days, although it may be less.

Then, the meningococcus penetrates the mucosa and enters the bloodstream. The most common manifestation of this type of disease is meningitis or inflammation of the meninges — the membranes that cover the brain and spinal cord.

One of the possible effects of this disease is the development of meningococcal sepsis — a serious condition, with a high mortality rate. Likewise, those who survive it may have permanent sequelae.

A woman with fever.
Meningococcal sepsis can begin with the typical symptoms of meningitis such as fever and headache.

Keep reading: What is Meningitis?

Meningococcal sepsis

This condition is a form of septic shock. The latter is a medical condition in which the tissues and organs don’t receive enough oxygen and nutrients. This leads to the gradual death of cells and a general failure that can lead to death.

Then there’s the multiplication of meningococcus in the blood. This excess leads to clots that hinder circulation in one or more organs or extremities, causing gangrene. Paradoxically, difficult-to-control hemorrhages also occur.

Estimates indicate that one in four people with this disease will require the amputation of a limb. Likewise, sepsis causes skin lesions that generate scars and lead to deformities. These often require surgery and the healing process is rather slow.

Symptoms and manifestations

The symptoms of meningococcal sepsis are broad. At first, there may be a mild fever and yet there’s also multi-organ failure and death within hours, in many cases.

Typically, symptoms common to those of any viral infection appear such as fever, chills, dizziness, nausea, headache, and weakness in the first four to six hours. There may also be diarrhea and vomiting.

In addition to these above, the most common symptoms of sepsis are:

  • Pale and blotchy skin
  • Accelerated breathing
  • Trembling hands and feet
  • Drowsiness and confusion
  • Low blood pressure
  • Pain in the joints or limbs
  • A rash in the form of small, bright red spots that together look like a fresh bruise (it doesn’t happen in all cases)

Diagnosis and treatment

Meningococcal sepsis can happen with or without meningitis. Typically, the diagnosis is made from a blood test, nasal, and jaw swab, chest X-ray, and stool sample.

Treatment of the disease must take place in a hospital or medical facility and doesn’t require isolation. The conventional approach includes the following four measures:

  • The administration of antibiotics must happen early on and any visible source of infection must be drained.
  • Parenteral hydration is carried out in order to fill the vascular space and maintain blood pressure to prevent extreme hypotension.
  • The use of vasoactive drugs to counteract the cardiocirculatory changes that, in turn, are the result of inflammation caused by sepsis.
  • Life support measures include oxygen administration, tracheal intubation, and mechanical ventilation; also, coagulants and fresh frozen plasma when there’s bleeding.
A person getting a vaccine.
Meningococcal vaccines are helpful in decreasing the circulation of these kinds of bacteria in the population.

You may also be interested in Urinary Sepsis: Causes and Treatments

Prevention of meningococcal sepsis

This is primarily about preventing the spread of meningococcal disease. Thus, there are two vaccines available for this purpose:

  • The pneumococcal vaccine protects against pneumococcal meningitis. Doctors routinely apply it to infants and often to people over 65. There are speculations about it leading to a cross-reaction and prevent meningococcal infections due to the similarity. In any case, one can’t say it’s entirely effective against S. pneumoniae.
  • The MenC vaccine offers protection against the group of meningococci type C. Doctors use it on babies and it’s also available to anyone under 25 years of age.

Vaccines don’t protect against all types of meningococci. However, they greatly reduce the distribution of the bacteria most associated with the problem. Finally, other prevention guidelines are: limiting contact with sick people, frequent hand washing, and proper hygiene of objects for personal use.

  • Wilhelm, J., & Villena, R. (2012). Historia y epidemiología del meningococo. Revista chilena de pediatría, 83(6), 533-539.
  • Solórzano-Santos, F., Ortiz-Ocampo, L. A., Miranda-Novales, M. G., Echániz-Avilés, G., Soto-Noguerón, A., & Guiscafré-Gallardo, H. (2005). Serotipos prevalentes de Streptococcus pneumoniae colonizadores de nasofaringe, en niños del Distrito Federal. salud pública de méxico, 47(4), 276-281.
  • Navalón, I. C., Herrejón, E. P., & Torralba, J. J. (2003). Sepsis meningogócica. Una enfermedad rara, grave y potencialmente letal. ¿Existe alguna alternativa al tratamiento? ¿ Cuál es el papel de la proteína C activada? Puesta al día en urgencias, emergencias y catástrofes, 4(1), 6-11.
  • Arnáiz-García, María Elena, et al. “Mutilating purpura fulminans in an adult with meningococcal sepsis.” Puerto Rico Health Sciences Journal 36.3 (2017): 179-182.
  • de Tena, J. García, et al. “Protocolo diagnóstico del rash cutáneo y fiebre en adultos.” Medicine-Programa de Formación Médica Continuada Acreditado 12.59 (2018): 3485-3491.
  • Vázquez, E. García, et al. “Infecciones por meningococo.” Medicine-Programa de Formación Médica Continuada Acreditado 11.58 (2014): 3407-3411.
  • Pedraz, J., and Eduardo López-Bran. “Protocolo diagnóstico de los exantemas cutáneos eritematopurpúricos.” Medicine-Programa de Formación Médica Continuada Acreditado 12.48 (2018): 2872-2876.
  • Cid, Jesús López Herce. “¿ Debe administrarse tratamiento antibiótico prehospitalario en la sospecha de sepsis meningocócica?.” Evidencias en pediatría 2.4 (2006): 1.
  • Klugman, Keith P. “Eficacia y efectividad de las vacunas antineumocócicas conjugadas.” Vacunas: Prevención de enfermedades, protección de la salud. Washington: OPS-OMS (2004): 114-8.
  • Artola, Beatriz Sánchez. “Tratamiento de las infecciones graves por Neisseria meningitidis (meningococo).” Revista Electrónica de Medicina Intensiva Artículo C11 (2004).