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Harrison's Principles of Internal Medicine, 18e
| Part 8. Infectious Diseases > Section 6. Diseases Caused by Gram-Negative Bacteria > |
Chapter 143. Meningococcal Infections
Sections: Meningococcal Infections: Introduction, Further Readings.
Topics Discussed: meningococcal infections.
Excerpt:"Infection with Neisseria meningitidis most commonly manifests as asymptomatic colonization in the nasopharynx of healthy adolescents and adults. Invasive disease occurs rarely, usually presenting as either bacterial meningitis or meningococcal septicemia. Patients may also present with occult bacteremia, pneumonia, septic arthritis, conjunctivitis, and chronic meningococcemia.Up to 500,000 cases of meningococcal disease are thought to occur worldwide each year, and  10% of the individuals affected die. There are several patterns of disease: epidemic, outbreak (small clusters of cases), hyperendemic, and sporadic or endemic.A nonblanching rash (petechial or purpuric) develops in >80% of cases of meningococcal disease; however, the rash is often absent early in the illness. Usually initially blanching in nature (macules, maculopapules, or urticaria) and indistinguishable from more common viral rashes, the rash of meningococcal infection becomes petechial or frankly purpuric over the hours after onset. In the most severe cases, large purpuric lesions develop (purpura fulminans). Some patients (including those with overwhelming sepsis) may have no rash. While petechial rash and fever are important signs..."
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