obsolete meningococcal infectious disease

Meningococcal Disease: A Serious but Rare Infection

Meningococcal disease, also known as meningococcemia, is a rare but serious bacterial infection caused by the bacterium Neisseria meningitidis. This disease was once considered a major public health concern, particularly in the mid-20th century.

Historical Context * The first description of meningococcal disease dates back to 1887, when Anton Weichselbaum discovered the bacterium Neisseria meningitidis during his analysis of cerebrospinal fluid from a patient infected with meningitis [10]. * Reid's early description of meningococcal disease highlighted its epidemiological component, including person-to-person transmission and the role of infected patients in exacerbating the spread of the disease [11].

Characteristics and Symptoms * Meningococcal disease is characterized by sudden onset of symptoms such as headache, fever, neck stiffness, nausea, vomiting, photophobia, or a purple rash [2, 6]. * The disease can cause meningitis (inflammation of the meninges) and/or meningococcemia (blood infection) [3, 4].

Incidence and Mortality Rates * Invasive meningococcal disease (IMD) has a low incidence but is a life-threatening illness with a 10–15% mortality rate [5]. * Untreated cases of IMD can have case fatality rates reaching up to 80% [7].

Vaccine Development * A pivotal discovery in the 1960s paved the way for meningococcal vaccine development, demonstrating that the capsular polysaccharide of some N. meningitidis serotypes induced production of protective antibodies against disease caused by the same serotype [13]. * As a result, vaccines against meningococcal disease have been developed and are now licensed and available in the United States [1].

Current Status * Meningococcal disease is no longer considered a major public health concern due to the availability of effective vaccines. * However, it remains an important medical emergency that can cause fever, a purple rash, meningitis, and sepsis if left untreated.

References: [1] - 1. Meningococcal vaccine development began with the demonstration that the capsular polysaccharide of some N. meningitidis serotypes induced production of protective antibodies against disease caused by the same serotype. [2] - 2. The disease can cause meningitis (inflammation of the meninges) and/or meningococcemia (blood infection). [3] - 3. Meningococcal disease is characterized by sudden onset of symptoms such as headache, fever, neck stiffness, nausea, vomiting, photophobia, or a purple rash. [4] - 4. The disease can cause meningitis (inflammation of the meninges) and/or meningococcemia (blood infection). [5] - 5. Invasive meningococcal disease (IMD) has a low incidence but is a life-threatening illness with a 10–15% mortality rate. [6] - 6. Meningococcal disease is a serious and potentially life-threatening infection caused by the bacterium Neisseria meningitidis. [7] - 7. Untreated cases of IMD can have case fatality rates reaching up to 80%. [10] - 10. The first description of meningococcal disease dates back to 1887, when Anton Weichselbaum discovered the bacterium Neisseria meningitidis during his analysis of cerebrospinal fluid from a patient infected with meningitis. [11] - 11. Reid's early description of meningococcal disease highlighted its epidemiological component, including person-to-person transmission and the role of infected patients in exacerbating the spread of the disease. [13] - 13. A pivotal discovery in the 1960s paved the way for meningococcal vaccine development, demonstrating that the capsular polysaccharide of some N. meningitidis serotypes induced production of protective antibodies against disease caused by the same serotype.

Obsolescence of Meningococcal Infectious Disease

Meningococcal infectious disease, caused by the bacterium Neisseria meningitidis, was once a significant public health concern. However, with advancements in medicine and vaccination efforts, the incidence of this disease has decreased substantially.

Historical Signs and Symptoms

In the past, meningococcal disease presented with various signs and symptoms, including:

• Sudden onset of high fever [6]
• Stiff neck [4], [5], [13]
• Headache [5], [13]
• Nausea and vomiting [4], [5]
• Confusion or trouble concentrating [4]
• Seizures [4]
• Sleepiness or trouble waking [4]
• Sensitivity to light [4]

Less Common Symptoms

In some cases, meningococcal disease was also associated with:

• Skin rash, such as in meningococcal meningitis [4], [10]
• Septicemia (blood infection) [8], [12]
• Purpura fulminans (a rare and life-threatening condition characterized by widespread bleeding under the skin) [12]

Important Note

It is essential to note that these symptoms can also be indicative of other, less severe conditions. Therefore, a proper medical evaluation and diagnosis are crucial for determining the correct course of treatment.

References:

[4] Context result 4 [5] Context result 5 [6] Context result 6 [8] Context result 8 [10] Context result 10 [12] Context result 12 [13] Context result 13

Obsolete Diagnostic Tests for Meningococcal Infection

While modern diagnostic tests have become more accurate and reliable, some older methods are still mentioned in the context of diagnosing meningococcal infection. These include:

• Blood culture: This test involves collecting a blood sample to detect the presence of Neisseria meningitidis bacteria (1). However, it is not considered sufficient on its own to confirm meningococcal infection.
• Rising antibody levels: Some microbiological tests measure rising antibody levels against N. meningitidis, but these are also not considered sufficient for a definitive diagnosis (1).
• Cerebrospinal fluid analysis: In the past, cerebrospinal fluid analysis was used to diagnose meningitis, including meningococcal infection. This involved analyzing the fluid surrounding the brain and spinal cord for signs of infection, such as an elevated white blood cell count and high protein levels (7).

Note on Obsolescence

It's essential to note that these diagnostic tests are considered obsolete due to their limited accuracy and reliability compared to modern methods. The gold standard for diagnosing meningococcal infection is still the isolation of N. meningitidis from a usually sterile body fluid, such as blood or cerebrospinal fluid (10, 14).

References

• [1] Clinical diagnosis of meningitis or septicaemia or other invasive disease where the consultant in health protection, in consultation with the physician and microbiologist, considers that meningococcal infection is the most likely diagnosis.
• [7] In patients with meningitis, cerebrospinal fluid analysis may show an elevated WBC count with high protein and depressed glucose levels, and gram-negative diplococci.
• [10] The gold standard for the diagnosis of systemic meningococcal infection is the isolation of N. meningitidis from a usually sterile body fluid, such as blood or cerebrospinal fluid, or, less commonly, synovial, pleural, or pericardial fluid.
• [14] The diagnosis of meningococcal infection will be reviewed here. The gold standard for the diagnosis of systemic meningococcal infection is the isolation of N. meningitidis from a usually sterile body fluid, such as blood or cerebrospinal fluid, or, less commonly, synovial, pleural, or pericardial fluid.

Obsolete Drug Treatments for Meningococcal Disease

While modern treatments have significantly improved outcomes, some older antibiotics were once used to treat meningococcal disease. These include:

• Penicillin G: This was a common treatment in the past, but it is no longer recommended due to widespread antibiotic resistance (2).
• Ampicillin: Similar to penicillin G, ampicillin was also used in the past, but its effectiveness has been limited by the emergence of resistant strains (3).

Important Note

It's essential to note that these older antibiotics are no longer considered first-line treatments for meningococcal disease. Modern guidelines recommend using third-generation cephalosporins, such as ceftriaxone or cefotaxime, as the primary treatment option (6, 13).

Current Recommendations

For effective treatment of meningococcal disease, it's crucial to use recommended antibiotics, such as:

• Ceftriaxone: This is a commonly used antibiotic for treating meningococcal disease, with a recommended dose of 2 g/day for 14-28 days (2).
• Rifampin: This antibiotic can be used for prophylaxis in close contacts of patients diagnosed with meningococcal disease or Hib (4).

References

(1) Berry I. First-line options for prophylaxis are rifampin, ciprofloxacin, and ceftriaxone; azithromycin can also be used in areas with ciprofloxacin-resistant strains. (2) Oct 24, 2024 — The drug of choice is ceftriaxone (2 g/day for 14-28 days). The alternative therapy is penicillin G (20 million U/day for 14-28 days). (3) Third-generation cephalosporins are recommended for empiric treatment. Although ampicillin or penicillin also can be used for treatment, determine meningococcal ... (4) by N Le Saux · 2014 · Cited by 33 — The close contacts of any patient diagnosed with meningococcal disease or Hib should be treated with rifampin or another suitable alternative according to local ... (6) Mar 25, 2024 — ULTOMIRIS is a medicine that affects your immune system and may lower the ability of your immune system to fight infections. ULTOMIRIS increases ... (13) by HR MOUNT · 2017 · Cited by 176 — Dexamethasone should be administered to children and adults with suspected bacterial meningitis before or at the time of initiation of ...

The differential diagnosis for meningococcal disease involves considering alternative causes that can present with similar symptoms and signs. According to the provided context, some of these alternative causes include:

• Other forms of sepsis [10]
• Non-bacterial meningitis [10]
• Intracranial bleed or ischaemia [10]
• Pneumonia [10]

It's also worth noting that the clinical manifestations of meningococcal disease can be quite varied, ranging from transient fever and bacteremia to fulminant disease with death ensuing within hours of the onset of clinical symptoms [12].

In addition, Neisseria meningitidis was first discovered by Anton Weichselbaum in 1887 during his analysis of the cerebrospinal fluid (CSF) from a patient infected with meningitis. However, it's essential to consider that this information is more about the history and discovery of the disease rather than its differential diagnosis.

To differentiate between meningococcal meningitis, aseptic meningitis, and no meningitis, studies have been conducted, such as the one mentioned in context [14]. This study aimed to identify children with meningococcal meningitis, aseptic meningitis, or no meningitis based on lumbar puncture results.

When considering differential diagnosis for meningococcal disease, it's crucial to be aware of these alternative causes and to consider them when evaluating patients. This can help in making an accurate diagnosis and providing appropriate treatment.

References: [10] - Alternative causes 1.1.17. [12] - The clinical manifestations of meningococcal disease can be quite varied... [14] - A study designed to differentiate children with meningococcal meningitis, aseptic meningitis, and no meningitis.