Meningococcemia: Everything you need to know
The hallmark sign of meningococcemia is a rash that does not fade under pressure. The rash can appear anywhere on the body due to damaged blood vessels allowing blood to "leak" into the skin.
Meningococcemia can occur at any age, but babies and young children are most at risk.
Direct contact with fluids from a person's nose and throat, such as from sneezing, are the easiest ways to spread the disease. Overcrowding, sharing dining utensils, and kissing are also risk factors.
Doctors must diagnose and treat meningococcemia as quickly as possible. If a person receives treatment later, they can experience serious complications, such as hearing loss, mental disability, and amputation.
In this article, we look at the symptoms of meningococcemia, how a doctor would diagnose it, and how to treat it. We also explain how best to prevent meningococcemia.
What is meningococcemia?
A person with meningococcal disease may experience a fever and chills in the early stages.
According to the World Health Organization (WHO), meningococcemia is a blood infection due to the bacteria Neisseria meningitidis.
When someone has meningococcemia, bacteria enter the bloodstream and multiply, damaging blood vessels throughout the body and causing bleeding into the skin and organs. This can lead to a significant rash.
While the infection can occur in anyone, infants under 2 years of age and adolescents are the most at risk.
The mortality rate for meningococcemia is up to 40%.
It can take 2 to 10 days from initial exposure to the bacteria before people begin showing any symptoms of meningococcal disease.
Anyone displaying early symptoms must contact a doctor immediately as the disease can quickly become life threatening.
In its earliest stages, meningococcal disease causes flu-like symptoms, including:
- fever and chills
- fatigue (feeling tired)
- cold hands and feet
- muscle or joint pain
- rapid breathing
The most characteristic sign of meningococcemia develops within hours. This sign is a hemorrhagic rash that appears on the skin that does not fade or lose color when someone presses a glass against it.
Not everyone develops a rash, however. Infants can also have additional symptoms, including a bulging fontanelle (soft spot) and a limp appearance.
Image credit: CDC/ Mr. Gust, 1965.
Image credit: Vishal S, Mukul AP, Giri S, 2010.
Image credit: Kernéis S, Mahé E, Heym B, Sivadon-Tardy V, Bourgeois F, Hanslik T, 2009.
Meningococcemia occurs when N. meningitidis enter a person's bloodstream and damage blood vessels, causing bleeding into the skin and organs.
However, someone that is colonized with these bacteria will not always contract meningococcemia. According to the Centers for Disease Control and Prevention (CDC), the bacteria will enter the bloodstream in less than 1% of colonized people.
According to the Meningitis Research Foundation of Canada, up to 20% of people carry N. meningitidis in the back of their noses and throats without having symptoms. Any carrier can transmit the bacteria to other people.
The bacteria spread via direct contact with tiny droplets that come out of a person's nose or mouth. These droplets may reach another person through:
- sharing cutlery or food
- sharing drinks from the same container
- sharing lipstick, cigarettes, or toothbrushes
N. meningitidis can also cause meningococcal meningitis, another serious infection. It affects the membranes that surround the brain and spinal cord and may occur with meningococcemia or on its own.
Diagnosing meningococcemia in its earliest stages can be difficult, as it is easy for people to mistake some of the milder symptoms for cold or flu.
However, a doctor will start treatment of antibiotics as a precaution if they suspect meningococcemia is present.
Most cases of meningococcemia cause visible skin changes, along with other symptoms. A person can detect signs of meningococcemia by checking all over the body for a rash that does not fade when they apply pressure.
People with darker skin should pay particular attention to the soles of their feet and palms of their hands, or other lighter parts of the skin where the rash will be more visible.
Doctors may take fluid from the spinal cord or the rash to test for meningococcal bacteria with a gram stain.
A gram stain is a test that uses a series of dyes on a sample to identify bacteria.
A polymerase chain reaction (PCR) test can detect N. meningitidis DNA in the blood, even in the disease's earliest stages.
Meningococcemia needs urgent treatment with antibiotics. With fast treatment, meningococcemia is less likely to become life threatening.
Doctors will treat even suspected meningococcemia with antibiotics due to the severity of the disease and risk of septic shock. Early treatment reduces the risk of complications such as gangrene or brain damage.
For this reason, doctors may also treat people who have come into close contact with someone with meningococcemia.
A 24-hour course of antibiotics helps limit the spread of bacteria, but many doctors will prescribe a 7-day course. A continuous dose of antibiotics can remove the bacteria altogether.
In severe cases of meningococcemia, both skin and tissue can lose oxygen flow. If this happens, doctors may need to amputate the affected digit or limb.
The CDC suggest the best defense against meningococcal diseases is keeping up to date with recommended vaccines.
Keeping a routine of healthful habits, such as getting enough sleep and avoiding close contact with people who are sick, also helps.
Getting vaccines is crucial for people with HIV, who are at higher risk of getting meningococcemia.
Individuals who come into close contact with a person with meningococcemia should ask the doctor for antibiotics to prevent getting sick.
Doctors in the United States use different types of meningococcal vaccines, including MenACWY and MenB.
Children may receive a routine MenACWY vaccination between the ages of 11 and 12 years old, with a booster shot when they are 16. Those who receive the vaccine at 16 years of age or older do not need a booster.
Doctors can give the MenB vaccine to people aged 16–23. They can also give it to children 10 years old or above who have an increased risk of contracting the infection.
Children and adults at risk of the infection may receive different vaccines at various times.
Different strains of the bacteria exist in other countries, so the vaccine that protects people from meningococcal bacteria in the U.S. may not do so abroad. Always consult a doctor before going abroad in case more vaccinations are necessary.
Meningococcemia is a serious type of blood poisoning. Some people can develop physical, neurological, and psychological complications as a result of meningococcemia.
The bacteria that cause meningococcemia damage blood vessels, blocking the flow of oxygen to major organs and tissues, which can lead to:
- skin and tissue damage
- organ failure
- limb loss
However, if doctors diagnose and treat the infection with antibiotics early, people with meningococcemia can make a full recovery.