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$Unique_ID{BRK03995}
$Pretitle{}
$Title{Meningitis, Meningococcal}
$Subject{Meningitis Meningococcal Meningococcal Meningitis Bacterial
Meningococcal Meningitis Epidemic Cerebrospinal Meningitis Meningitis
Encephalitis Rocky Mountain Spotted Fever }
$Volume{}
$Log{}
Copyright (C) 1990 National Organization for Rare Disorders, Inc.
805:
Meningitis, Meningococcal
** IMPORTANT **
It is possible the main title of the article (Meningitis, Meningococcal)
is not the name you expected. Please check the SYNONYMS listing on the next
page to find alternate names and disorder subdivisions covered by this
article.
Synonyms
Meningococcal Meningitis
Bacterial Meningococcal Meningitis
Epidemic Cerebrospinal Meningitis
Information on the following disorders may be found in the Related
Disorders section of this report:
Meningitis
Encephalitis
Rocky Mountain Spotted Fever
General Discussion
** REMINDER **
The information contained in the Rare Disease Database is provided for
educational purposes only. It should not be used for diagnostic or treatment
purposes. If you wish to obtain more information about this disorder, please
contact your personal physician and/or the agencies listed in the "Resources"
section of this report.
Meningococcal Meningitis is a form of meningitis caused by a specific bacteria
known as Neisseria meningitidis. Meningitis is characterized by inflammation
of the membranes (meninges) around the brain or spinal cord. This inflammation
can begin suddenly (acute) or develop gradually (subacute). Symptoms may
include fever, headache, and a stiff neck, sometimes with aching muscles.
Nausea, vomiting and other symptoms may occur. Skin rashes occur in about
half of all patients with Meningococcal Meningitis. Treatment with
antibiotics and other drugs is usually effective against this infection.
Symptoms
Meningococcal meningitis is one of the three most common types of bacterial
meningitis. It progresses more rapidly than any other acute form of
bacterial meningitis. Meningococcal Meningitis involves the central nervous
system. In adults and children it is often preceded by respiratory illness
or a sore throat. In its acute form, the disorder is characterized by fever,
headache, a stiff neck, and vomiting. Adults may become seriously ill within
hours. In children the course of the infection may be even shorter.
Symptoms among older children and adults may progress from irritability
to confusion, drowsiness, and stupor, possibly leading to coma. Skin rashes
occur in about half of all patients with Meningococcal Meningitis. Swelling
or inflammation of the brain (cerebral edema, ventriculitis), or
hydrocephalus (accumulation of fluid in the brain cavity) may also occur.
Other symptoms may include chills, sweating, weakness, loss of appetite,
muscle pain (myalgia) of the lower back or legs, or inability to tolerate
bright light (photophobia). (For more information on hydrocephalus, choose
"hydrocephalus" as your search term in the Rare Disease Database).
Dehydration often occurs, and collapse of the blood vessels may lead to
shock (Waterhouse-Friderichsen Syndrome) when the meningococcus bacteria
spreads to the blood (septicemia). Later symptoms may include paralysis of
one side of the body (hemiparesis), hearing loss, or other neurological
abnormalities.
The course of Meningococcal Meningitis is less predictable among infants
between 3 months and 2 years of age. Fever, refusal of feedings, vomiting,
irritability, and convulsions usually occur. A high-pitched cry, and a
bulging or tight soft spot (fontanel) on the crown of the head (where the
parts of the skull's still unhardened bones join) may also occur. Since the
incidence of most types of Meningitis is highest among this age group, any
unexplained fever needs to be closely watched. Cerebral fluid may accumulate
just inside the tough outer membrane covering the brain (subdural effusions)
after several days. Warning signs may include seizures, a persistent fever,
and an enlarging head size. A brain abscess or subdural pus accumulation may
also occur. Water accumulating in the brain (hydrocephalus), deafness and
slowed mental and physical development are possible consequences of
Meningitis.
Causes
Meningococcal Meningitis is caused by a bacteria known as Neisseria
meningitidis. There are several types, or serogroups, of Neisseria
meningitidis. The most common of these serogroups are A, B, C, D, X, Y, 29E,
and W135. Serogroups A, B, C, and Y are responsible for most meningococcal
diseases.
The bacteria is spread by droplets in the air or close contact with an
infected person. It collects in the nasopharynx, or post-nasal space, that
connects the nasal cavities with the throat. The bacteria is transported to
the membranes (meninges) around the brain or spinal cord by the blood. It
usually spreads from nearby infected areas such as the nasal sinuses, or from
the cerebrospinal fluid.
Affected Population
Meningococcal Meningitis primarily affects infants, children, and young
adults. Males are affected slightly more than females. Meningococcal
Meningitis can occur as an epidemic in subgroups such as people in the
military services or students in dormitories. Vaccines can help control
meningitis epidemics caused by serogroups A, C, Y, or W135.
In the United States, most cases of Meningococcal Meningitis involve
infants and military recruits, and tend to be caused by serogroup B of the
bacteria. It occurs most often during winter or spring. Between 1984 and
1986, 2,400 to 2,700 cases of meningococcal infection were reported annually
in the United States.
Related Disorders
Symptoms of the following disorders may resemble those of Meningococcal
Meningitis. Comparisons may be useful for a differential diagnosis:
In general, Meningitis is characterized by inflammation of the membranes
(meninges) around the brain or spinal cord. This inflammation may be caused
by different types of bacteria, viruses, fungi, malignant tumors, or
reactions to certain injections into the spinal canal. (For more
information on other types of Meningitis, choose "meningitis" as your search
term in the Rare Disease Database).
Encephalitis is a brain infection. There are different types of this
disorder which are caused by different types of viruses. Encephalitis may
also be caused by hypersensitivity initiated by a virus or other protein that
is foreign to the body. Symptoms may include headache, drowsiness,
hyperactivity, and/or general weakness. This disorder may have some symptoms
similar to those of Meningitis such as a stiff neck, altered reflexes,
confusion, speech disorders, convulsions, paralysis and coma. (For more
information choose "Encephalitis" as your search term in the Rare Disease
Database).
Rocky Mountain Spotted Fever is an acute infectious disorder transmitted
to humans through the bite of an infected tick, usually in wooded areas of
the midwest, eastern and southeastern United States. Fever and rash are
among major symptoms. The rash may not develop in all cases, possibly making
diagnosis difficult. Swelling (edema), headache, chills, weakness and muscle
pains may also occur. Severe headaches, lethargy, confusion, delirium, focal
neurological deficits, increased pressure in the skull leading to pressure
on and swelling of the optic disk (papilledema), seizures and/or coma may
occur in untreated cases as the nervous system is progressively affected.
Some patients may have a stiff neck due to muscle pain (myalgia) or
irritation of membranes surrounding the brain and spinal cord tissue
(meningismus). (For more information on this disorder, choose "Rocky
Mountain Spotted Fever" as your search term in the Rare Disease Database).
Therapies: Standard
Testing for Meningococcal Meningitis may include imaging techniques such as
CT scans or magnetic resonance imaging (MRI). Other testing may include
examination of the patient's blood and/or skin. Diagnosis is made by
examination of the cerebrospinal fluid.
Meningococcal Meningitis is usually treated with antibiotic drugs used
against the bacteria causing the infection. Penicillin G or ampicillin are
often prescribed. Alternative drugs include chloramphenicol, cefuroxime,
cefotaxime, ceftriaxone, or ceftizoxime. Family members of those infected
can be treated with Rifampin as a preventative measure; however, for pregnant
women, ceftriaxone is recommended.
Epidemics caused by the bacteria (Neisseria meningitidis) serogroups A,
C, Y, or W135 can be controlled with a meningococcal vaccine that prevents
infection in vaccinated people.
Therapies: Investigational
This disease entry is based upon medical information available through August
1990. Since NORD's resources are limited, it is not possible to keep every
entry in the Rare Disease Database completely current and accurate. Please
check with the agencies listed in the Resources section for the most current
information about this disorder.
Resources
For more information on Meningococcal Meningitis, please contact:
National Organization for Rare Disorders (NORD)
P.O. Box 8923
New Fairfield, CT 06812-1783
(203) 746-6518
NIH/National Institute of Allergy and Infectious Diseases (NIAID)
9000 Rockville Pike
Bethesda, MD 20892
(301) 496-5717
Centers for Disease Control (CDC)
1600 Clifton Road, NE
Atlanta, GA 30333
(404) 639-3534
References
CECIL TEXTBOOK OF MEDICINE, 18th Ed.: James B. Wyngaarden, and Lloyd H.
Smith, Jr., Editors; W.B. Saunders Co., 1988. Pp. 65, 1604-1621.
INTERNAL MEDICINE, 2nd Ed.: Jay H. Stein, ed.-in-chief; Little, Brown
and Co., 1987. Pp. 1494-1502, 1666-1669.
BACTERIAL MENINGITIS IN OLDER CHILDREN. W.A. Bonadio, et al.; Am J Dis
Child (Apr 1990; issue 144 (4)). Pp. 463-465.
CEFTRIAXONE ALONE COMPARED TO AMPICILLIN AND CHLORAMPHENICOL IN THE
TREATMENT OF BACTERIAL MENINGITIS. N.I. Girgis; Chemotherapy (1988; issue 34
(Suppl 1)). Pp. 16-20.
CONTROL OF AN OUTBREAK OF GROUP C MENINGOCOCCAL MENINGITIS WITH A
POLYSACCHARIDE VACCINE. R. G. Masterton, et al.; J Infect (Sept 1988; issue
17 (2)). Pp. 177-182.
Gd-DTPA-ENHANCED MR IMAGING OF THE BRAIN IN PATIENTS WITH MENINGITIS:
COMPARISON WITH CT. K. H. Chang, et al.; AJR Am J Roentgenol (April 1990;
issue 154 (4)). Pp. 809-816.