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Recognizing meningococcal disease

BY CAROLE MOLONEY, RN, MSN, CPNP

credit: Science Photo Library – CNRI/SPL/Brand X Pictures/Getty Images

Fever, runny nose, vomiting, and diarrhea are all common symptoms that likely each of us has had at some point in our lives. Most often, they are self-limited and caused by viruses, but they also may be the first signs of a serious illness caused by the bacteria Neisseria meningitidis. The lack of specificity of presenting symptoms is the exact reason that meningococcal disease, whatever the serotype, is frequently difficult to diagnose in its earliest stages. It presents like so many self-limiting viral illnesses, which can thereby potentially lead to delayed diagnosis and treatment; for example, it is often misdiagnosed as influenza.


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The lack of specificity of presenting symptoms is the exact reason that meningococcal disease, whatever the serotype, is frequently difficult to diagnose in its earliest stages.

Meningococcal disease often occurs without warning, even among people who are otherwise healthy.

The highest incidence of meningitis infection occurs in those individuals less than 1 year of age; however there is a second risk period – at 16-21 years of age – likely associated with an increase in at-risk behaviors, such as alcohol consumption, exposure to cigarette smoke, sharing food or beverages, and activities that involve the exchange of saliva. Additionally, living on a college campus or in a fraternity or sorority can be a risk factor.

Symptoms may differ among age groups. Infants often exhibit fever, irritability, poor feeding, and lethargy. Older children and adults may complain of severe headache, stiff neck, chills, sensitivity to bright light, malaise, and sleepiness, in addition to nausea and vomiting. Exacerbation of symptoms can happen quickly. An early, short-lived salmon-colored rash may or may not be present. The presence of petechiae or purpura is often a sign of progression and heralds deterioration.

Carole Moloney, CPNP

 

 

The highest incidence of meningitis infection occurs in those individuals less than 1 year of age; however there is a second risk period – at 16-21 years of age – likely associated with an increase in at-risk behaviors, such as alcohol consumption, exposure to cigarette smoke, sharing food or beverages, and activities that involve the exchange of saliva.

Prompt recognition of the disease is imperative for the appropriate treatment to be initiated.

The illness can progress very rapidly and have devastating consequences, which can lead to significant morbidity and mortality. Even when treated, meningococcal disease kills 10-15 out of 100 people infected. In those who survive, about 10-20 out of every 100 will suffer disabilities such as hearing loss, brain damage, kidney damage, amputations, and central nervous system problems, according to the Centers for Disease Control and Prevention.

Ms. Moloney is a certified pediatric nurse practitioner in the division of pediatric infectious diseases at Boston Medical Center. She disclosed that she is a speaker for Sanofi Pasteur and is on their adolescent immunization initiative committee.