Submitted by:

SABILI, JANEN
SARENO, MA. ELISA

Submitted to:
MR. ROMEO RIVERA
Clinical Instructor
MENINGOCOCCEMIA

Definition:
- Meningococcemia is the dissemination of meningococci into the
bloodstream and is a medical emergency, making early recognition of
the disease essential.

CHAIN OF INFECTION

Infectious
Infectious
Agent
Agent
Susceptible
Susceptible
Host
Host (Neisseria
(Neisseria
Meningitidis
Meningitidis

Portalof
Portal of
Entry
Reservoir
Reservoir
Entry
(Mucous
(Mucous
(HUMAN)
membranes))
membranes MENIGOCOCCEMIA (HUMAN)

Modeofof
Mode Portalofof
Portal
Transmission
Transmission Exit
Exit

(Droplet
(Droplet (Respiratory
(Respiratory
Spread)
Spread) Secretions))
Secretions

CAUSATIVE AGENT:

- Meningococcemia is caused by Neisseria meningitidis, an encapsulated

gram-negative diplococcus. Meningococci (0.6 µm X 0.8 µm) are gram-
 negative single cocci or diplococci with flattened adjacent sides. Older
cultures can vary considerably in size and shape. Serotyping is based
on the polysaccharide capsule. The organisms grow at 35-37°C in a
moist oxygen-reduced atmosphere containing 5-19% carbon dioxide on
media that contains blood.

RESERVOIR
- Neisseria meningitidis lives in the upper respiratory tract of every
human; therefore human is the only natural reservoir of the
meningococci.

PORTAL OF EXIT
- The portal of exit of the pathogens is through respiratory secretions.

MODE OF TRANSMISSION
- The infection can transmit the organisms through droplets.

PORTAL OF ENTRY
- The pathogen usually enters the body through the mucous membranes
of the nasopharynx.

SUSCEPTIBLE HOST

- In the United States, the incidence of meningococcal disease is higher

in blacks and in lower socioeconomic groups. Meningococcal disease is
somewhat more prevalent in males (1.2 cases per 100,000) than in
females (1 case per 100,000). In epidemics of meningococcal disease,
people of any age may be affected, with the case distribution shifted
toward older individuals. Endemic meningococcal disease is most
common in children aged 6-36 months. Children younger than 6
months are protected by maternal antibodies. In New York City, from
1989-2000, the overall incidence rates of meningococcal disease
decreased. This was more evident in the younger age groups, and this
increased the median age of patients from 15 years in 1989-1991 to
30 years in 1998-2000. Occult meningococcemia is an uncommon form
of infection that affects children aged 3-24 months.

Incubation Period: 2-10 days (3-4 days average)

CLINICAL MANIFESTATIONS

EARLY
High grade fever in the first 24 hours
Weakness
Joint and muscle pain
Spotty red and purple rash
LATE
Widespread purpura and ecchymoses
Signs of meningeal irritation:
-headache
-nausea/vomiting
-stiff neck
Seizure and convulsions
 (petechiae)

Diagnostic Examinations:
1. Blood Culture
2. Complete Blood Count
3. Lumbar Puncture
4. Skin Biopsy and Staining
5. Urinalysis

Treatment:
• ANTIBIOTICS
-Penicillin G
-Ceftriaxome
-Cefotaxime
-Trimethoprim

Prevention:
1. Respiratory Isolation
2. Vaccination

Nursing Management
1. Standard precautions
2. Seizure precautions
3. Wearing of personal protective equipments

PATHOPHYSIOLOGY
 N. Meningitidis is transmitted through
droplets

Pathogen enters the

nasopharyngeal tract

N. Meningitidis attaches to the nasopharyngeal

epithelial cells

Bacterium binds to the human cell surface

protein CD46

Meningococci enters the bloodstream

The pathogen spreads in the

meninges and other parts of Impairment of protein
the body C anticoagulation
pathway

The
Fevebacteria then release
r endotoxins Development of
bact petecchia and purpura
eria
then
relea Vasculitis or
se inflammation
endo
toxin
s