infectious diseases
Meningococcal Diseases
Symptoms and Signs of Meningococcal Diseases
Patients with Acute Bacterial Meningitis frequently report fever, headache, and stiff neck. Other symptoms include nausea, vomiting, photophobia, and lethargy. A maculopapular or hemorrhagic petechial rash often appears soon after disease onset. Meningeal signs are often apparent during physical examination. Fulminant meningococcemia syndromesinclude Waterhouse-Friderichsen syndrome (septicemia, profound shock, cutaneous purpura, adrenal hemorrhage), sepsis with multiple organ failure, shock, and disseminated intravascular coagulation. A rare, chronic meningococcemia causes recurrent mild symptoms (mostly joint and cutaneous). Complicationsof meningococcal meningitis are common and serious. Of patients who recover, 10 to 20% have serious sequelae, such as permanent hearing loss, intellectual disability, or loss of phalanges or limbs. Fulminant meningococcemia initially causes petechiae, which become confluent and rapidly progress to ecchymoses. Image courtesy of Mr. Gust via the Public Health Image Library of the Centers for Disease Control and Prevention. Petechiae and purpura are visible on the child's face. Hemorrhagic return from the nasogastric tube is consistent with disseminated intravascular coagulation, also secondary to meningococcemia. © Springer Science+Business Media © Springer Science+Business Media Image courtesy of Karen McKoy, MD. Petechiae and purpura secondary to meningococcemia are widespread. Lesions tend to be common on the trunk and lower extremities. © Springer Science+Business Media Petechiae are isolated in some areas and coalescent and developing necrosis in other areas (left). A large area of necrosis is seen (right). © Springer Science+Business Media 