Meningococcal infection is an acute disease caused by the meningococcus bacterium, variably presenting from localized nasopharyngitis to severe meningococcemia and meningitis. The disease has a seasonal incidence pattern, primarily affecting children under 5, with airborne transmission primarily in close contact settings. Common symptoms include high fever, severe headache, and distinctive rashes, with serious forms leading to potential severe complications like hydrocephalus and intellectual disabilities.

1. Meningococcal infection
acute infectious disease caused by meningococcus with an airborne
mechanism of transmission of the pathogen and a variable clinic:
from localized forms with damage to the mucous membrane of the
nasopharynx (nasopharyngitis) to generalized forms
(meningococcemia and meningitis).

2. • Classification of meningococcal
4 GROUPS:
• A, B, C, D.
• W- 135.
• Features of the epidemic process at the present stage
periodic rises in the incidence rate on average after 10-12 years;the inverse
dependence of the intensity of the rise in morbidity on the level of morbidity
during the recession and a direct relationship with the duration of the
interepidemic period;The prevalence in various territories is characterized at first
by outbreaks in closed collectives, then in certain areas and only after 2-3 years an
increase in rural areas;The seasonal rise in morbidity begins in November-
December, reaches a maximum in March-April;children under 5 years of age
account for up to 50-90% of all diseases, with a decrease in morbidity, the
proportion of young children increases;low foci: up to 95% - foci with 1 case of
the disease. The duration of the hearth in children's groups is no more than 1
month.

3. • The transmission path is airborne in close contact.
Meningococcal infection is characterized by:
Seasonality
Age distribution
Periodicity.
Children under 10 years old are sick, more often children under 1 year old.
n the interepidemic period, young children are more likely to get sick
(80%).
In the epidemic period, older children.
Seasonality : maxi- February-April.
The frequency of the rise in 10-15 years.

4. • Sources of infection:
• Patients with meningococcemia and meningitis.
• Patients with nasopharyngitis.
• Healthy carriers.
• The most dangerous patients are at the end of the prodromal period
and the first two days of the manifest form of the disease.
• The duration of the infectious period is determined by the length of
stay of meningococcus in the nasopharynx and lasts from 3 weeks to
6 months.

5. • Pathogenesis.
• Nasopharyngeal and pharyngeal mucosa
• Overcome local and protective barriers
Through the lymphatic pathways into the blood
Skin joints kidneys adrenal glands heart lungs
Generalized vascular endothelial damage
BAS (cyclic thromboxane, serotonin, histamine, kinins)
Increased vascular permeability
Diapedesis of erythrocytes
Hemorrhagic rash
Meningococci overcome the blood-brain barrier
Purulent meningitis Purulent meningoencephalitis

6. • Classification of meningococcal infection
• 1.TYPE
• Typical
• Meningococcemia
• Meningitis
• Mixed form (meningococcemia +meningitis)
• Atypical
• Localized:Meningococcal Disease,
• Generalized nasopharyngitis:
• Arthritis (synovitis, polyarthritis), endocarditis, iridocyclitis.
• 2. Severity
• Easy
• Medium-heavy
• Heavy

7. • 3. Current
• Abortive(5 days)
• Acute (1 month)
• Subacute(1.5 months)
• Prolonged (up to 3 months)
• Chronic
• The incubation period is 2
• -10 days (more often 3-5 days)
Meningococcal disease- meningococcus on the mucous
membrane of the nasopharynx without any clinical
manifestations.
Meningococcal nasopharyngitis:
T° rise, lasts 2-4 daysModerate intoxicationSore and sore throatPallor of the faceInjection of
scleraHyperemia and granularity of the posterior pharyngeal wall, soft palate, and anterior arches.Nasal
breathing is difficult, speech acquires a nasal tingeNasal congestion or a small viscous dischargeModerate
leukocytosis, ESR-N or slightly elevatedThe disease lasts 5-7 days

8. • Differential diagnosis with acute respiratory infections
• Only nasopharyngitis.No- coughing, sneezing, laryngitis, tracheitis, bronchitis, inflammatory changes on the back
wall of the pharynx.The data of the epidanamnesis are also different.Only the sowing of meningococcus helps to
finally make the correct diagnosis.
• Meningococcemia:
• - An acute beginning The rise of t° to high numbersGeneral intoxication
• Skin rashes
• ° reaction is of the wrong type from 2-3 to 8-10 days.-
• - lethargy, hyperesthesia of the skin
• Headache, vomiting, decreased appetiteDecrease in diuresisShortness of breath.
• Skin rashes 5-8 hours after the onset of the disease - hemorrhagic stellate rash with superficial necrosis in the
center.
• Extravasates (bacterial blood clots)
• The rash rises above the skin, does not disappear when pressed
• When scraping, meningococcus can be isolated from them.
• The favorite localization of the rash is the outer surfaces of the thighs and shins, buttocks, feet, lower abdomen
• In the blood - leukocytosis, left-shifted neutrophilosis, increased ESR (Erythrocyte sedimentation rate),
coagulogram disorder

9. • Severe form.
• Rapid growth of a large hemorrhagic rash with drain elements
• Deep necrosis (engulfs the skin and underlying tissues) - with tissue defects during scarring
• Nasal, intestinal, uterine bleeding
• Myocarditis is often present
• Meningitis.
• An acute onset, parents can name not only the day, but also the hour when the child fell ill
• t° rise to high digits
• Severe bursting headache
• Pain in the eye balls
• Repeated vomiting is not associated with eating and does not bring reliefSevere hyperesthesiaFrom the first
hours, all signs of damage to the meninges are sharply expressed (rigidity of the occipital muscles, Kernig
syndrome, Brudzinsky, etc.)Abdominal pain as a manifestation of radicular syndromeThere is high leukocytosis
with neutrophilosis, accelerated ESR, and aneosinophilia in the blood.
• In young children.
• - Starting with a sharp cry, anxiety, general convulsionsMeningeal symptoms are less pronouncedPositive
symptoms of Lessage ("hanging")Swelling or tension of the large fontanelleSevere hyperesthesiaDiarrheal
syndrome.

10. • Meningococcal meningitis in children of the 1st year of life
• Prevalence of general infectious and cerebral syndrome;Meningeal symptoms are less pronounced or appear
later;The onset of the disease is acute, in 10% it is gradual;Often, catarrhal symptoms – nasopharyngitis -
appear first;cerebral/meningeal symptoms for only 2-3 days are the cause of ARVI, and the rash that appears
is allergic;In some cases, gastrointestinal dysfunction – repeated regurgitation, vomiting, loose stools.
• Cerebral syndrome:
• Unmotivated anxiety;Weeping;Flinching, crying out during sleep;Within a few hours, the child becomes
sluggish, unemotional, refuses to eat;Changing periods of excitement and depression;Often generalized
tonic-clonic seizures, reflecting the severity of cerebral edema; against the background of cerebral edema,
there is depression of consciousness, more often to the point of constipation or coma.
• Meningeal syndrome
• It appears later - on 2-3 days and is less pronouncedThe most diagnostic significance is:Rigidity of the
occipital muscles,The symptom of hanging – Lessage,The symptoms of Brudzinsky and Kernig are unstable
and it is impossible to focus on them when diagnosing the disease.Tension of the large fontanelle.
• NB! The condition of the fontanel should be assessed in a calm state of the child (preferably during sleep),
because with anxiety, crying, the fontanel is strained in healthy children. Severe hypertension, manifested in
severe anxiety, crying, during any manipulation: feeding, swaddling, trying to pick up ("a symptom of
maternal hands"). More often, a complicated course of meningitis with timely treatment (ventriculitis or
ependymatitis).

11. • Meningococcal meningitis in adolescents
• Acute onset with febrile fever, severe intoxication,Bursting headache in the eyeballs,Hyperesthesia for all types of
stimuli,Repeated vomiting, unrelated to food intake,From the first hours of the disease, the MENINGEAL complex
is pronounced,Sometimes severe abdominal pain as a manifestation of radicular syndrome is the reason for
suspected appendicitis.
• Meningeal symptoms
Rigidity of the muscles of the occiput - the inability to bring the head to the chest (muscle tension).
• Kernig's symptom is the inability to fully extend the knee joint of the leg bent at the hip and knee joints (in
children under 4 months – physiological).
• Brudzinsky's symptom is lower – with passive extension of the leg bent in the hip and knee joints, involuntary
flexion of the other leg occurs in the same joints
• Brudzinsky's symptom is a moderate (pubic) flexion in the hip and knee joints when pressing on the pubis.
• The symptom of Lessage is pulling the legs up to the stomach and holding them in this position when lifting the
child under the armpits.
• Lumbar puncture
• Increased intracranial pressure
• Changing the color of liquor and its transparency
• Cellular-protein dissociation(neutrophilic pleocytosis, moderate increase in protein content)

12. • Meningoencephalitis.
• From the first days of the disease, focal symptoms appear, in the form of lesions of individual TBI on the
background of impaired consciousnessGeneral or local seizuresThe current is very heavyDuration 4-6
weeksThe prognosis is unfavorable The outcome is epilepsy, hydrocephalus, and severe psychomotor
retardation.
• Focal symptoms ---Encephalitis
• ----Cerebral edema
• Cerebral edema of the I, II, III degree
• Infectious and toxic shock of I, II, III degree
• Hydrocephalusacute
• renal failure
• DIC syndrome (Disseminated blood clots in blood vessels)
• Cerebral hypotension
• Dural effusion
• Ependymatitis

13. • Complications (specific late)
• Intellectual disability
• Hypertension syndrome
• Hydrocephalus
• Epileptic syndrome
• Paralysis and paresis
• Necrosis of the skin and subcutaneous fat
• Hearing impairment
• Endocrine disorders (diabetes insipidus, diencephalic obesity)