Meningococcal infections Flashcards
What is meningitis?
Meningitis describes inflammation of the meninges (membranes) which cover the brain and spinal cord
What are the 3 layers of meninges?
- dura mater
- arachnoid mater
- pia mater
What is meningitis usually caused by?
- by infection with
- Bacteria e.g. meningococcus, pneumococcus
- Viruses e.g. coxsackievirus, echovirus, herpes virus, mumps virus, influenza, HIV etc
- Less common infective causes include fungi, protozoa, and other parasites
What are some non-infectious causes? (rarer)
- Medications e.g. antibiotics (amoxicillin, trimethoprim/sulfamethoxazole), carbamazepine, lamotrigine, NSAIDs, ranitidine
- Cancers e.g. melanoma, lung cancer, breast cancer, lymphoma, leukaemia
- Autoimmune disease e.g. Systemic lupus erythematosus (SLE), Behçet’s syndrome
What is the differential diagnosis for meningitis?
- Viral meningitis
- Fungal meningitis
- TB meningitis
- Drug-induced meningitis
- Sepsis from other causes
- Encephalitis – inflammation of the brain
- Brain abscess – collection of pus in the brain
- Subarachnoid haemorrhage
- Brain tumour
- HIV infection
What is invasive meningococcal disease caused by?
Infection with Neisseria meningitidis
- Gram-negative diplococci
What are the 2 main manifestations of invasive meningococcal disease?
- Meningitis: a localised infection of the meninges, with “local” symptoms
- Only causes meningeal symptoms
- Septicaemia: a systemic infection with widespread signs, and generalised organ damage
- Many organs
What is invasive meningococcal disease spread by?
- Transmitted by aerosol, droplets, or direct contact with secretions from the upper respiratory tract
- Transmission usually requires either frequent or prolonged close contact
- Commonly affects extremes of age (<2 months and >60 years) because of impaired or waning immunity
What are risk factors for invasive meningococcal disease?
- Extremes of age
- Immunocompromised (e.g. HIV) or immunosuppressed (e.g. chemotherapy)
- Asplenia/hyposplenia
- No spleen → more likely to get infected
- Cancer – people with leukaemia and lymphoma
- Sickle cell disease
- Organ dysfunction – e.g. liver or kidney disease
- Contiguous infection - e.g. otitis media, sinusitis, mastoiditis, pneumonia
- Smokers
- No cilia, more likely to get infected
- Living in overcrowded households, college dormitories or military barracks
What are symptoms of invasive meningococcal disease?
- Fever
- Stiff neck
- Headache
- Confusion
- Increased sensitivity to light
- Nausea and vomiting
What are symptoms of invasive meningococcal disease in babies?
- slow or inactive
- irritable
- vomiting
- feeding poorly
- or have a bulging anterior fontanelle (the soft spot of the skull)
What is Brudzinki’s neck sign?
- Pulling baby’s head up automatically draws legs up
- To reduce tension on the meninges
What are meningococcal septicaemia symptoms
- Fever and chills
- Fatigue
- Vomiting
- Cold hands and feet
- Severe aches or pain in the muscles, joints, chest, or abdomen
- Rapid breathing
- Diarrhoea
- Non blanching rash (petechiae)
- In the later stages, a dark purple rash (purpura)
Do you have to notify meningococcal diseases?
Yes, notifiable disease
- Notify your regional UKHSA health protection team of
- Meningitis (any cause)
- Meningococcal septicaemia
- Notify on suspicion
What is chemoprophylaxis?
- Antibiotics given to eradicate throat carriage
- So it doesn’t pass on to someone else
- Doesn’t stop infection in person
