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Meningococcemia

Meningococcal septicemia; Meningococcal blood poisoning; Meningococcal bacteremia

Meningococcemia is an acute and potentially life-threatening infection of the bloodstream.

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Causes

Meningococcemia is caused by bacteria called Neisseria meningitidis. The bacteria often live in a person's upper respiratory tract without causing signs of illness. They can be spread from person to person through respiratory droplets. For example, you may become infected if you are around someone with the condition and they sneeze or cough.

Family members and those closely exposed to someone with the condition are at increased risk. The infection occurs more often in winter and early spring.

Symptoms

There may be few symptoms at first. Some may include:

• Fever
• Headache
• Irritability
• Muscle pain
• Nausea
• Rash with very small red or purple spots on the feet or legs

Later symptoms may include:

• A decline in your level of consciousness
• Large areas of bleeding under the skin
• Shock

Exams and Tests

The health care provider will examine you and ask about your symptoms.

Blood tests will be done to rule out other infections and help confirm meningococcemia. Such tests may include:

• Blood culture
• Complete blood count with differential
• Blood clotting studies

Other tests that may be done include:

• Lumbar puncture to get a sample of spinal fluid for Gram stain and culture
• Skin biopsy and Gram stain and culture
• Urine analysis

Treatment

Meningococcemia is a medical emergency. People with this infection are often admitted to the intensive care unit of the hospital, where they are closely monitored. They may be placed in respiratory isolation for the first 24 hours to help prevent the spread of the infection to others.

Treatments may include:

• Antibiotics given through a vein immediately
• Breathing support
• Clotting factors or platelet replacement, if bleeding disorders develop
• Fluids through a vein
• Medicines to treat low blood pressure
• Wound care for areas of skin with blood clots

Outlook (Prognosis)

Early treatment results in a good outcome. When shock develops, the outcome is less certain.

The condition is most life threatening in those who also have:

• A severe bleeding disorder called disseminated intravascular coagulopathy (DIC)
• Kidney failure
• Shock

Possible Complications

Possible complications of this infection are:

• Arthritis
• Bleeding disorder (DIC)
• Gangrene due to lack of blood supply
• Inflammation of blood vessels in the skin
• Inflammation of the heart muscle
• Inflammation of the heart lining
• Shock
• Severe damage to adrenal glands that can lead to low blood pressure (Waterhouse-Friderichsen syndrome)

When to Contact a Medical Professional

Go to the emergency room immediately if you have symptoms of meningococcemia. Contact your provider if you have been around someone with the disease.

Prevention

Preventive antibiotics for family members and other close contacts are often recommended. Speak with your provider about this option.

A vaccine that covers some, but not all, strains of meningococcus is recommended for children age 11 or 12. A booster is given at age 16. Unvaccinated college students who live in dormitories should also consider receiving this vaccine. It should be given a few weeks before they first move into the dorm. Talk to your provider about this vaccine.

Related Information

Acute
Hypersensitivity vasculitis
Respiratory
Meningococcal meningitis
Bleeding disorders
Waterhouse-Friderichsen syndrome
Arthritis
Pericarditis

References

Marquez L. Meningococcal disease. In: Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJ, eds. Feigin and Cherry's Textbook of Pediatric Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 88.

Stephens DS, Apicella MA. Neisseria meningitidis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 211.

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Review Date: 12/4/2022  

Reviewed By: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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