Meningococcal sepsis is a medical emergency that, therefore, must be attended to with utmost haste. It is a disease that progresses rapidly and can lead to shock and simultaneous failure in various organs.
This condition stems from a meningococcal infection. The World Health Organization (WHO) estimates that there are around 500,000 new infections per year. Between 20 and 50% of those who develop meningococcal sepsis die.
This bacterium produces serious diseases that are acquired by contact with the droplets expelled by an infected person when coughing or sneezing.
Some individuals are very sensitive to these bacteria, but science does not know why. The truth is that this microorganism progressively invades the nasopharynx. The interval between contagion and the appearance of symptoms is about 10 days, although they may be less.
After this, meningococcus passes through the mucosa and enters the bloodstream. The most popular presentation of this kind of disease is meningitis or inflammation of the meninges, which are membranes that envelop the brain and spinal cord.
One of the possible effects of meningococcal disease is that meningococcal sepsis occurs. This is a very serious condition with a high mortality rate. Likewise, those who survive may have permanent consequences.
Meningococcal sepsis is a form of septic shock. The latter is a medical condition in which the tissues and organs do not receive sufficient oxygen and nutrients; This leads to gradual cell death and general failure that can lead to death.
The multiplication of meningococcus in the blood forms clots. These hinder circulation in one or more organs or extremities, causing gangrene. Paradoxically, illnesses that are difficult to control also occur.
It is estimated 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. The latter, frequently, must be treated with surgery and have a very slow healing process.
Symptoms and manifestations
The symptoms of meningococcal sepsis are very wide. A mild fever may appear at first, but there are many cases in which this translates into multi-organ failure and death within hours.
Typically, symptoms common to any viral infection occur in the first four to six hours: fever, chills, dizziness, nausea, headache, and weakness. May also Diarrhea and vomiting be present.
In addition to these manifestations, the typical symptoms of sepsis are the following:
- Pale and blotchy skin.
- Accelerated breathing.
- Tremors in cold hands and feet.
- Drowsiness and confusion.
- Low blood pressure.
- Joint or limb pain.
- Rash-like rash: The sepsis-derived rash has a small, bright red spot appearance. These can come together and take the form of recent bruising. Not all people in this condition have them.
Diagnosis and treatment
Meningococcal sepsis can present with or without meningitis. Typically, the diagnosis is made from a blood test, a nasal and maw swab, a chest x-ray, and a stool specimen.
Treatment of the disease is carried out in a hospital or medical center but does not require isolation. The conventional approach includes four measures:
- Administration of antibiotics: these must be given early. If there is a visible septic or infection focus, it should be drained.
- Fluids: parenteral hydration is carried out to fill the vascular space and support blood pressure so that extreme hypotension is not reached.
- Use of vasoactive drugs: These drugs 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. If bleeding occurs, coagulants and fresh frozen plasma are often used.
Prevention of meningococcal sepsis
First of all, the prevention of meningococcal sepsis has to do with avoiding the spread of meningococcal disease. There are two vaccines available to contribute to that purpose:
- Pneumococcal vaccine: protects against pneumococcal meningitis. It is routinely applied to babies and often to people over 65. It has been speculated that it may cross-react and similarly prevent meningococcal infections. In any case, at the moment, it should only be considered effective against S. pneumoniae.
- MenC: offers protection against the group of meningococci of type C. It applies to babies and is available to anyone under the age of 25.
Vaccines do not protect against all types of meningococci, but they greatly reduce the bacteria’s distribution most linked to the problem. Other prevention guidelines are the limitation of contact with sick people, frequent handwashing, and hygiene of objects for personal use.