Apparent Meningococcemia: Clinical Features of Disease Due to Haemophilus influenzae and Neisseria meningitidis

PEDIATRICS ◽  
1983 ◽  
Vol 72 (4) ◽  
pp. 469-472
Author(s):  
Richard F. Jacobs ◽  
Steven Hsi ◽  
Christopher B. Wilson ◽  
Denis Benjamin ◽  
Arnold L. Smith ◽  
...  
Keyword(s):  
Haemophilus Influenzae ◽  
Neisseria Meningitidis ◽  
Meningococcal Disease ◽  
Clinical Signs ◽  
Meningococcal Infection ◽  
Disseminated Intravascular Coagulopathy ◽  
Etiologic Agents ◽  
Intravascular Coagulopathy ◽  
Time Of Admission ◽  
Mean Time

To determine the etiology of apparent meningococcemia, all cases of sepsis with coagulopathy, purpura, and/or adrenal hemorrhage (Waterhouse-Friderichsen syndrome) with and without shock occurring over a 12-year period were reviewed. A total of 42 cases were identified; 30 cases were caused by Neisseria meningitidis and 12 cases were caused by Haemophilus influenzae. Compared with patients with disease caused by H influenzae, patients with meningococcal disease were older, more often male, more often contracted the disease in winter-spring, and had a longer duration of antecedent symptoms; however, none of these differences was statistically significant. All patients were febrile (>38°C) and appeared toxic. Similar proportions in each group had shock and disseminated intravascular coagulopathy at the time of admission. Ten of 12 patients with H influenzae infection compared with 15/30 (P < .05) with meningococcal infection were lethargic or comatose at the time of admission. Nine of 12 patients with H influenzae infection died compared with 5/30 with meningococcal disease (P < .005); the mean time from onset of symptoms to death with H influenzae infection (20.7 ± 11.4 [SE] hours) was significantly shorter (P < .05) than with meningococcal infection (120 ± 74.4 hours). Children with clinical signs of sepsis and with purpura, petechiae, or coagulopathy may have N meningitidis or H influenzae as etiologic agents. Initial antibiotic therapy should be directed against these pathogens.

scholarly journals Prospects for Vaccine Prevention of Meningococcal Infection

2006 ◽  
Vol 19 (1) ◽  
pp. 142-164 ◽  
Author(s):  
Lee H. Harrison
Keyword(s):  
United States ◽  
High Risk ◽  
Bacterial Meningitis ◽  
Neisseria Meningitidis ◽  
Meningococcal Disease ◽  
Risk Groups ◽  
The United States ◽  
Meningococcal Infection ◽  
Meningococcal Vaccine ◽  
The Military

SUMMARY Neisseria meningitidis is the leading cause of bacterial meningitis in the United States and worldwide. A serogroup A/C/W-135/Y polysaccharide meningococcal vaccine has been licensed in the United States since 1981 but has not been used universally outside of the military. On 14 January 2005, a polysaccharide conjugate vaccine that covers meningococcal serogroups A, C, W-135, and Y was licensed in the United States for 11- to 55-year-olds and is now recommended for the routine immunization of adolescents and other high-risk groups. This review covers the changing epidemiology of meningococcal disease in the United States, issues related to vaccine prevention, and recommendations on the use of the new vaccine.

Toxic Shock Syndrome in Two Dogs

2012 ◽  
Vol 48 (6) ◽  
pp. 434-438 ◽  
Author(s):  
Jennifer E. Slovak ◽  
Valerie J. Parker ◽  
Krysta L. Deitz
Keyword(s):  
Veterinary Medicine ◽  
Clinical Outcome ◽  
Toxic Shock Syndrome ◽  
Clinical Signs ◽  
Disease Process ◽  
Postmortem Examination ◽  
Toxic Shock ◽  
Disseminated Intravascular Coagulopathy ◽  
Intravascular Coagulopathy ◽  
Labrador Retrievers

Two young, unrelated, spayed female Labrador retrievers were evaluated for severe, diffuse, generalized erythema and edema of the skin. Both dogs exhibited signs of disseminated intravascular coagulopathy and were euthanized. On postmortem examination, toxic shock syndrome (TSS) was diagnosed based on histopathology and supported by skin cultures. TSS is a rarely reported disease in veterinary medicine and can cause acute and profound clinical signs. Rapid recognition of this disease process and immediate treatment may improve the clinical outcome.

scholarly journals An unusual transmission event of Neisseria meningitidis serogroup W135 type 2a in a healthcare setting, England, 2012

2012 ◽  
Vol 17 (44) ◽  
Author(s):  
R Puleston ◽  
C Beck ◽  
M Tahir ◽  
M Bardhan ◽  
P Charlemagne ◽  
...  
Keyword(s):  
Neisseria Meningitidis ◽  
Meningococcal Disease ◽  
Older Persons ◽  
Close Contact ◽  
Healthcare Setting ◽  
Meningococcal Infection ◽  
Elderly Persons ◽  
Transmission Event ◽  
Asymptomatic Individuals ◽  
Current Guidelines

We report an outbreak of Neisseria meningitidis serogroup W135, associated with a transient transmission event between asymptomatic individuals in a healthcare setting. Two elderly persons subsequently developed invasive meningococcal disease. The duration and type of close contact for those directly involved in the probable transmission incident would not have warranted chemoprophylaxis according to current guidelines. Meningococcal infection in older persons usually presents with pneumonia rather than meningitis or septicaemia with purpura.

Epidemiología de la meningitis producida por Haemophilus influenzae tipo b, Neisseria meningitidis y Streptococcus pneumoniae en niños de la Comunidad Valenciana, España

1998 ◽  
Vol 26 (149) ◽  
pp. 34 ◽  
Author(s):  
Mª Amparo Morant Gimeno ◽  
J. Díez Domingo ◽  
C. Gimeno ◽  
N. de la Muela ◽  
I. Pereiró ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Haemophilus Influenzae ◽  
Neisseria Meningitidis

Epidemiological Characteristics of Meningococcal Infection in Moscow

2020 ◽  
Vol 19 (2) ◽  
pp. 56-62
Author(s):  
M. I. Gritsay ◽  
M. A. Koroleva ◽  
N. N. Fomkina ◽  
I. S. Koroleva
Keyword(s):  
Young Adults ◽  
Mortality Rate ◽  
Incidence Rate ◽  
Meningococcal Disease ◽  
Invasive Meningococcal Disease ◽  
Meningococcal Infection ◽  
Epidemic Process ◽  
Epidemiological Features ◽  
Teenagers And Young Adults ◽  
Epidemiological Characteristics

Aims. The purpose of this study was to identify current epidemiological features of meningococcal infection in Moscow.Materials and methods. Cases of invasive meningococcal disease in Moscow from 2014 to 2018 and the biomaterial from patients with an invasive meningococcal disease were analyzed.Results. The features of the epidemic process of meningococcal disease in Moscow were revealed: increasing in the incidence rate involving teenagers and young adults into the epidemic process; meningococcal strains of serogroups W and A increased in the etiology of the invasive meningococcal disease; high mortality rate.Conclusions. It seems reasonable to recommend vaccination against meningococcal disease by including adolescents, young adults and persons over 65 years old.

scholarly journals MisR/MisS Two-Component Regulon in Neisseria meningitidis

2007 ◽  
Vol 76 (2) ◽  
pp. 704-716 ◽  
Author(s):  
Yih-Ling Tzeng ◽  
Charlene M. Kahler ◽  
Xinjian Zhang ◽  
David S. Stephens
Keyword(s):  
Neisseria Meningitidis ◽  
Target Genes ◽  
Inner Core ◽  
Consensus Sequence ◽  
Meningococcal Infection ◽  
Type I ◽  
Mobility Shift ◽  
Iron Assimilation ◽  
Wide Range ◽  
Two Component

ABSTRACT Two-component regulatory systems are involved in processes important for bacterial pathogenesis. Inactivation of the misR/misS system in Neisseria meningitidis results in the loss of phosphorylation of the lipooligosaccharide inner core and causes attenuation in a mouse model of meningococcal infection. One hundred seventeen (78 up-regulated and 39 down-regulated) potential regulatory targets of the MisR/MisS (MisR/S) system were identified by transcriptional profiling of the NMBmisR mutant and the parental wild-type meningococcal strain NMB. The regulatory effect was further confirmed in a subset of target genes by quantitative real-time PCR and β-galactosidase transcriptional fusion reporter assays. The MisR regulon includes genes encoding proteins necessary for protein folding in the bacterial cytoplasm and periplasm, transcriptional regulation, metabolism, iron assimilation, and type I protein transport. Mutation in the MisR/S system caused increased sensitivity to oxidative stress and also resulted in decreased susceptibility to complement-mediated killing by normal human serum. To identify the direct targets of MisR regulation, electrophoretic mobility shift assays were carried out using purified MisR-His6 protein. Among 22 genes examined, misR directly interacted with 14 promoter regions. Six promoters were further investigated by DNase I protection assays, and a MisR-binding consensus sequence was proposed. Thus, the direct regulatory targets of MisR and the minimal regulon of the meningococcal MisR/S two-component signal transduction system were characterized. These data indicate that the MisR/S system influences a wide range of biological functions in N. meningitidis either directly or via intermediate regulators.

Disseminated Intravascular Coagulopathy in Critically Ill Patients in Amman, Jordan

2021 ◽  
pp. 109980042110172
Author(s):  
Eman Mahmoud Qasim Emleek ◽  
Amani Anwar Khalil
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Scoring System ◽  
Elevated Serum ◽  
Underlying Disease ◽  
Disseminated Intravascular Coagulopathy ◽  
Period Prevalence ◽  
Lower Baseline ◽  
Intravascular Coagulopathy

Background: The disseminated intravascular coagulation (DIC) is under-recognized in critically ill patients. The International Society of Thrombosis and Haemostasis (ISTH; DIC) provides a useful scoring system for accurate DIC identification. The study investigated the period prevalence of ISTH DIC from 2015 to 2017 in critically ill patients. Methods: In this multi-center, retrospective observational study, we included all patients identified with a DIC code or medically diagnosed with DIC during all admissions. Based on ISTH DIC scores ≥ 5, patients were classified with overt DIC. Results: A total of 220 patients were included in this study. The period prevalence of DIC was 4.45%. The point prevalence of DIC has increased from 3.49% to 5.58% from 2015 to 2017 (27.7% female; median age 61.6 years). Based on the ISTH-Overt DIC criteria, 45.2% of the sample had sepsis. Overt DIC patients had significantly lower baseline hemoglobin (HB; t = 2.137, df = 193, p = 0.034), platelet count ( t = 3.591, df = 193, p < 0.001) and elevated serum creatinine level ( M = 2.1, SD = 1.5, t = 2.203, df = 193, p = 0.029) compared to non–Overt DIC. There was a statistically significant elevation in FDPs among Overt DIC compared to non–Overt DIC (χ2 = 30.381, df = 1, p < 0.001). Overt DIC patients had significantly prolonged PT ( U = 2,298, z = 5.7, p < 0.001), PTT ( U = 2,334, z = 2.0, p = 0.045) and INR ( U = 2,541, z = 5.1, p < 0.001) compared to those with non–Overt DIC. Conclusion: The ISTH overt-DIC score can be used in critically ill patients regardless of the underlying disease. Efforts are required to predict and identify overt DIC using a valid scoring system on admission and follow-up of adult patients admitted to ICU.

Immunogenicity of Haemophilus influenzae Type b Polysaccharide-Neisseria meningitidis Outer Membrane Protein Conjugate Vaccine in 2- to 6-Month-Old Infants

PEDIATRICS ◽  
1987 ◽  
Vol 80 (2) ◽  
pp. 283-287
Author(s):  
Allen A. Lenoir ◽  
Paul D. Granoff ◽  
Dan M. Granoff
Keyword(s):  
Membrane Protein ◽  
Haemophilus Influenzae ◽  
Neisseria Meningitidis ◽  
Outer Membrane Protein ◽  
Geometric Mean ◽  
Serum Antibody ◽  
Haemophilus Influenzae Type ◽  
Antibody Concentration ◽  
Haemophilus Influenzae Type B ◽  
Type B

Fifty infants, 2 to 6 months of age, were vaccinated with Haemophilus influenzae type b capsular polysaccharide covalently linked to an outer membrane protein from Neisseria meningitidis group B. Subjects were given two injections and were randomly assigned to receive the injections separated by 1 or 2 months. Each dose contained 15 µg of polysaccharide and 51 µg of protein, or approximately twice the amount of polysaccharide as used in our previous trial (Lancet 1986;2:299). Fevers of 38.0° to 38.8°C developed in three infants (6%) within 24 hours after vaccination, but there were no other notable reactions. Following one injection, the geometric mean antibody concentration increased from 0.13 µg/mL in preimmune serum to 1.50 µg/mL in serum obtained 1 to 2 months later (P &lt; .001). After a second injection, there was a further increase in serum antibody (geometric mean = 3.11 µg/mL, P &lt; .007). The geometric mean antibody concentration of the group reimmunized 2 months after the first injection was higher than that in the group reimmunized after 1 month (3.95 v 2.32 µg/mL, P = .05, by analysis of covariance with age as the covariant). These data confirm our previous preliminary observations on the safety and immunogenicity of this new conjugate vaccine in infants 2 to 6 months of age. The data suggest that a 2-month interval between the first and second injections results in higher levels of serum antibody than a 1-month interval.

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