Meningococcemia It is caused by bacteria called Neisseria meningitidis.

The bacteria frequently lives in a person's upper respiratory tract without causing visible signs of illness. The bacteria can be spread from person to person through respiratory droplets -- for example, you may become infected if you are around someone with the condition when they sneeze or cough. Family members and those closely exposed to someone with the condition are at increased risk. The infection occurs more frequently in winter and early spring. Risk Factors Children and adolescents 5 to 19 years of age are at highest risk for meningococcemia. Patients who have a history of a specific genetic deficiency in the complement system are at high risk for severe disease. People who have been in close contact with an infected patient are at increased risk to acquire the disease themselves. Incubation Period 2-10 days with an average of 3-4days Clinical Manifestation There may be few symptoms at first. Some may include: Fever Headache Irritability Muscle pain Nausea Rash with red or purple spots (petechiae) Later symptoms may include: Changing level of consciousness Large areas of bleeding under the skin (purpura) Shock Complications

Arthritis Disseminated intravascular coagulopathy (DIC) Gangrene due to lack of blood supply Inflammation of blood vessels in the skin (cutaneous vasculitis) Myocarditis Pericarditis Shock Severe damage to adrenal glands that can lead to low blood pressure (Waterhouse-Friderichsen syndrome)

Diagnostic Tests Blood tests will be done to rule out other infections and help confirm meningococcemia. Such tests may include: Blood culture Complete blood count with differential Clotting studies (PT, PTT) Other tests that may be done include: Lumbar puncture to get a sample of spinal fluid for CSF culture Skin biopsy and Gram stain

 Urinalysis Medical Management Antibiotics given through a vein (IV), given immediately Breathing support Clotting factors or platelet replacement -- if bleeding disorders develop Fluids through a vein (IV) Medications to treat low blood pressure Wound care for areas of skin with blood clots Nursing Management Assess and maintain airway, breathing and circulation. Obtain a vascular access and initiate an intravenous infusion. Obtain blood specimens for laboratory analysis as prescribed. Administer medications as prescribed. Reassess the childs neurologic and cardiopulmonary status. Monitor intake and output carefully Inform the family frequently of the childs condition. Provide emotional support to the child and family Prevention People who have come into close contact with an infected patient should strongly consider taking antibiotics to reduce the risk of disease. For caretakers and health-care workers, frequent hand washing is recommended to minimize the transfer of infected secretions to the mouth or nose. In the hospital, patients with meningococcemia are placed in private rooms and staff will wear surgical masks when approaching the patient. There is an effective and safe vaccine to protect against most serogroups of meningococcus that cause meningococcemia. Unfortunately, no effective vaccine exists for serogroup B. For the other major diseasecausing serogroups (A, C, Y, W135), there are two vaccines available in the United States: the meningococcal polysaccharide vaccine (Menomune, MPSV4) and the meningococcal conjugate vaccine (Menactra, Menveo, MCV4). The choice of vaccine depends on the age of the patient. The vaccine is recommended starting at 11 years of age. A booster dose is given at 16 years of age. Older teens who have never been vaccinated need only a single dose.

REFERENCE MedlinePlus: Meningococcemia retrieved from www.nlm.nih.gov/medlineplus/ency/article/001349.htm last June 27, 2013 Meningococcemia retrieved from www.medicinenet.com/meningococcemia/article.htm last June 27, 2013

Aklan State University School of Arts and Sciences Bachelor of Science in Nursing Banga, Aklan

In Partial Fulfillment of the Requirements in Related Learning Experience

(Meningococcemia)

Submitted by Angel Luz B. Resco BSN 4-2

Submitted to Jocelyn Suner, RN Clinical Instructor