Meningococcemia

Excerpt

One of the most serious and life-threatening infectious diseases during childhood is bacteremia, a consequence of which is septic shock, where inadequate perfusion of tissues occurs due to endotoxemia. Neisseria meningitidis (Meningococcus) is an important bacterial infection manifesting as meningitis or septicemia, or more often a combination of both. Asymptomatic pharyngeal colonization is the initial step of infection, with humans being the natural reservoirs. From the nasopharynx, the coccus reaches the meninges translocating across the nasopharyngeal mucosa and along the perineural sheath of the olfactory nerve, through the cribriform plate of the ethmoid. Bloodstream spread to the meninges will cause meningitis. In some children, the predominant feature is cardiovascular collapse leading to septic shock.

Transmission occurs by respiratory droplets and requires close direct contact. Children younger than 5 years do not have adequate immunity against the polysaccharide antigens of N. meningitidis. The risk factors for infectious disease in child care facilities include immunologic susceptibility, lack of awareness, and practice of good hygiene, a natural tendency to intimacy, frequent oral contact with objects in the environment.

The invasive meningococcal disease is seen in 2 age groups: infants who are vulnerable due to disappearance in the early life of the maternal antibodies and adolescents with a high rate of colonization of the nasopharynx.