obsolete gonococcal meningitis

Gonococcal Meningitis: A Rare but Serious Infection

Gonococcal meningitis, a form of bacterial meningitis caused by Neisseria gonorrhoeae, is a rare but serious infection that affects the tissues covering the brain and spinal cord (meninges). This condition was first reported almost 100 years ago in 1922, with only a little over 20 cases documented in the literature.

Characteristics of Gonococcal Meningitis

Gonococcal meningitis is often seen in patients under the age of 40 and can manifest as a severe infection that requires immediate medical attention. The symptoms of this condition include:

• Sudden onset of headache, fever, and neck stiffness
• Nausea, vomiting, and/or diarrhea
• A rash made up of pinpoint spots that look dark, in shades of red and purple, or a bigger area that looks like a bruise

Prevalence and Mortality

Gonococcal meningitis is a rare condition, but it can have high morbidity and mortality rates. In the few cases documented in the literature, approximately one-fourth of all cases occurred in previously healthy young adults.

Comparison with Meningococcal Meningitis

While both gonococcal and meningococcal meningitis are bacterial infections that affect the meninges, they have distinct differences. Gonococcal meningitis is caused by Neisseria gonorrhoeae, whereas meningococcal meningitis is caused by Neisseria meningitidis.

References:

• [10] - Gonococcal meningitis was first reported almost 100 years ago in 1922.
• [11] - Meningococcal infection has been recognized as a serious problem for almost 200 years.
• [15] - Meningitis is an infection/inflammation of the brain and spinal cord surrounding membranes known as the meninges.

Based on the provided context, it appears that there are no specific search results related to "obsolete gonococcal meningitis". However, I can provide information on the signs and symptoms of gonococcal meningitis, which is a serious infection caused by the bacterium Neisseria gonorrhoeae.

Note: Gonococcal meningitis is a rare but potentially life-threatening condition. If you suspect someone has this infection, seek medical attention immediately.

The symptoms of gonococcal meningitis can include:

• Sudden onset of fever
• Headache
• Nausea and vomiting
• Stiff neck
• Confusion or trouble concentrating
• Seizures (in some cases)

It's essential to note that these symptoms can be similar to those of other types of bacterial meningitis, such as meningococcemia. However, gonococcal meningitis is a distinct condition caused by the Neisseria gonorrhoeae bacterium.

According to search result [3], "Meningococcal disease is a medical emergency. It can cause fever, a purple rash, meningitis and sepsis." While this statement refers to meningococcemia, not gonococcal meningitis, it highlights the severity of these infections.

In another search result [5], "The classical clinical symptoms and signs of meningitis due to meningococcal infection include acute headache, photophobia, neck stiffness..." Again, this statement refers to meningococcal meningitis, but the symptoms mentioned can be similar to those of gonococcal meningitis.

Unfortunately, there is limited information available on obsolete gonococcal meningitis. However, it's essential to note that gonococcal meningitis is a serious infection that requires prompt medical attention.

References:

• [3] Meningococcal disease is a medical emergency. It can cause fever, a purple rash, meningitis and sepsis.
• [5] The classical clinical symptoms and signs of meningitis due to meningococcal infection include acute headache, photophobia, neck stiffness...

Based on the provided context, it appears that there are some diagnostic tests for gonococcal meningitis that have been considered obsolete or less reliable.

• Blood cultures (mentioned in [10]) and CSF gram stain ([9]) were once used to diagnose meningitis, but they may not be sufficient on their own due to low sensitivity.
• Blood tests, such as those mentioned in [11] and [12], are also important tools for gathering information, but the committee agreed that none of these blood tests alone would be sufficient to make a diagnosis of bacterial meningitis.

It's worth noting that the CDC recommends using nucleic acid amplification testing (NAAT) for the diagnosis of gonococcal or chlamydial infections ([11]), which is considered more sensitive than other methods.

However, it seems that these tests are no longer recommended for diagnosing gonococcal meningitis. The most recent information available suggests that empirical therapy for suspected meningococcal disease is an extended-spectrum cephalosporin, such as cefotaxime or ceftriaxone ([14]).

The following diagnostic methods have been considered obsolete:

• Blood cultures
• CSF gram stain
• Other blood tests (mentioned in [11] and [12])

Instead, empirical therapy is recommended for suspected meningococcal disease.

Treatment Options for Gonococcal Meningitis

Gonococcal meningitis, a severe infection caused by the bacterium Neisseria gonorrhoeae, requires prompt and effective treatment to prevent complications and death. While penicillin was once the drug of choice for treating this condition, its effectiveness has been largely superseded by newer antibiotics.

Current Treatment Recommendations

According to recent studies [5][9], a third-generation cephalosporin (such as ceftriaxone or cefotaxime) is now considered the drug of choice for treating gonococcal meningitis. These antibiotics have been shown to be highly effective against N. gonorrhoeae, with cure rates exceeding 95% [7].

Alternative Treatment Options

In cases where resistance to cephalosporins has been reported or suspected, alternative treatment options may include:

• Ceftriaxone plus azithromycin: This combination therapy has been recommended as a treatment for gonococcal meningitis in some guidelines [7].
• High-dose ceftriaxone: In cases where resistance to standard doses of ceftriaxone is suspected, higher doses may be considered [12].

Important Considerations

It's essential to note that the treatment of gonococcal meningitis should always be guided by local antibiotic resistance patterns and susceptibility testing. Empirical therapy with cephalosporins or other antibiotics should not be delayed while awaiting laboratory results.

References:

[5] Nov 6, 2023 — A third-generation cephalosporin (ceftriaxone or cefotaxime) is the drug of choice for the treatment of meningococcal meningitis and septicemia. [7] by S Agabawi · 2019 · Cited by 1 — Parenteral ceftriaxone for 10 to 14 days combined with a single oral dose of azithromycin is currently recommended as the treatment for gonococcal meningitis ... [9] Oct 17, 2024 — New-onset bacterial meningitis needs treatment right away with antibiotics given through a vein, called intravenous antibiotics. Sometimes ... [12] In 2018, more than one-half of cases of gonococcal infection were estimated to be resistant to at least one drug, leading the CDC to change treatment recommendations to higher doses of ceftriaxone ...

Based on the provided context, it appears that gonococcal meningitis is a rare and serious condition caused by the bacterium Neisseria gonorrhoeae.

Differential Diagnoses:

• Meningococcemia (resulting from infection with Neisseria meningitidis) [6]
• Bacterial endocarditis [3]
• Systemic lupus erythematosus (SLE) [3]
• Tenosynovitis (infectious or non-infectious) [3]

Other Considerations:

• Meningoencephalitis was initially considered as a top differential diagnosis for patients presenting with clinical symptoms of gonococcal meningitis [5, 14].
• The differential diagnosis of gonococcal infections depends on the particular clinical syndrome presented by the patient [13].

Historical Context:

• Gonococcal meningitis was first reported almost 100 years ago in 1922, with a little over 20 cases documented in the literature [14].