Acute Meningococcaemia

A Dermatological Emergency

Definition

• Meningococcaemia (meningococcal septicaemia)

– The presence of meningococci (bacteria of the species Neisseria meningitidis) in the bloodstream.

• Communicable disease• Affects children most commonly

• Can kill otherwise healthy children in hours.

Dermatological changes

• Non-blanching• Purpuric rash• +/- Oedema• May start at any site• Spreads• Lesions are irregular in size and outline,

with a necrotic core.

Diagnosis

• Glass test

Pathogenogesis of dermatological findings

• Septicaemia... Endotoxin- and cytokine- lead vasculitis...

• Microthrombi and haemorrhage in small vessels...

• Vascular Injury results in Ecchymosis

Management• ABCDE

• Any febrile child with a purpuric rash should be given systemic Antibiotics immediately and admitted urgently to hospital.

• IM Benzyl Penicillin 1.2g at GP Surgery

• Hospital – ICU if shocked

• Contacts

Complications

• Septicaemic shock • Disseminated Intravascular Coagulation (DIC)• Multi-organ failure • Death

Conclusion

• Acute Meningococcaemia is potentially fatal and should be treated as a medical emergency.

• Characteristic rash needs to be promptly recognised in order to reduce mortality.

• An example of skin manifestation of a life threatening acute disease process.