Meningococcal infection, also known as meningitis, is caused by the bacterium Neisseria meningitidis. It can cause inflammation of the membranes surrounding the brain and spinal cord (meningitis) as well as a serious blood infection (meningococcemia). The main symptoms of meningitis include fever, headache, and vomiting. Diagnosis involves examination of cerebrospinal fluid and blood samples. Treatment requires administration of antibiotics such as penicillin. Prophylactic measures include vaccination and isolation of infected individuals.

1. MENINGOCOCCAL INFECTION
(MENINGITIS)
BY- VIKASH KUMAR
GROUP-55

2. WHAT IS MENINGOCOCCAL INFECTION?
• Meningococcal infection is an acute infectious disease of
the
human, caused by meningococcous Neisseria Meningitigis.
• The disease is characterized by damage of mucous
membrane of nasopharynx (nasopharingitis), generalization of
the process in form of specific septicemia (meningococcemia)
and inflammation of the soft cerebral membranes (meningitis).

3. ETIOLOGY:
• Causative organism is Neisseria Meningitigis
• It is small gramm-negative diplococcus, aerobic,
catalise and oxidase-positive, not-motile and possess
a polysaccharide capsule.
• The main serogroups of pathogenic organisms are A, B, C, D,
and W135, X, Y, Z and L. The bacterial membrane is a
lipopolysaccaride.

4. EPIDEMIOLOGY
• Meningococcal infections occur worldwide and are notifiable in
most countries. About two-thirds of cases occur in the first 5
years of life.
• Epidemic meningitis due to Neisseria meningitis (usually group
A) is common in a broad belt across sub-Saharan Africa and is
also seen in parts of Asia. In Europe and North America
bacterial meningitis is usually sporadic, with B and C strains
predominanting.

5. EPIDEMIOLOGY
• Human beings are the only source of infection.
• The sourses of infection are healthy carriers of meningoco
ccus,
the patients with meningococcal nasopharingitis and the p
atients with generalized forms of the disease.
• Infection is transmitted by air-borne route during talking,
sneezing and coughing.
• AGENT is unstable in environment.

6. EPIDEMIOLOGY
• Infection rate can increase d by 6-10 days times
during the cold season in epidemic outbreaks.
• Infants under 5 years are more susceptible to disease
• This is especially vivid in kindergarden, school,
hostels and in army. The disease persist long time in
close populated places.

7. PATHOGENESIS
• In meningococcal infection the entrance gates is mucous membrane
of nasopharynx.
• It is the place of the primary localization of the agent. Meningococci
cause inflammation of the mucous membrane of the upper
respiratory tract.
• . It leads to development of nasopharingitis.
• The stages of inculcation on the mucous membrane of nasopharynx
and penetration of meningococcus into the blood precede to
entrance of endotoxin into the blood and cerebrospinal fluid. It
promotes of the resistance of meningococcus to phagocytosis and

8. PATHOGENESIS
• Toxic and allergic compounds play an important role in
pathogenesis of meningococcal infection.
• Profuse prulent exudate on the surface eof the frontal and
temporal lobes of the brain looks like a pus cap.

9. CLINICAL MANIFESTATION
• The incubation period is 1-10 days, more frequently 5-7 days.
• Classification of the clinical forms of meningococcal infection:
I. Primarily localized forms:(meningococcal carrier state, acute
nasopharyngitis; pneumonia)
II. Gematogenously generalized forms: (meningococcemia; meningitis;
meningoencephalitis; mixed meningococcal infextion)
III. Rare forms: (endocarditis, arthritis, iridocyclitis)
:

10. • Acute nasopharyngitis: Main symptoms:
Headache, vertigo, pallor, dry cough, vertigo, sore
throat, odema ,
Hyperaemia of the posterior pharyngeal wall, stuffy nose.
Body Temperature elevated during 1-3 days, mucosal
inflammation
persist for 5-7 days and follicar hyperplasia to 2
weeks.

11. MENINGITIS
• It may start after meningococcal nasopharyngitis,
but sometimes primary symptoms of the disease arise sudde
nly.
• In meningitis three symptoms are revealed constantly:
fever(39-40 *C) , headache and vomiting.
• Headache is very intensive at the night. It increases due to
change of body position, sharp sounds, bright light.
In meningitis hyperthermia, hyperkynesia, photophobia,
hyperalgesia, hyperosmia are noticed, more common in child.

12. MENINGITIS
• severe convulsions arise in the many patients at the first ho
urs of the disease ( clonic, tonic or mixed types).
• By the end of the first day, or early on the second day , signs of
meningeal
involvement become apparent: Stiff neck (patient cannot bend his
head to touch the chest with the sign). Kernig symptom, Brudzinski
symptom.
-Abdomen is sunken, The legs are curved in knee-
joint and pelvic-femoral joint.

14. MENINGITIS
• Cranial nerve can be involved to cuse – strabismus , anisocoria ,
paresis of facial nerve and lesion of the acoustic and abducent
nerves.
• Delirium can developed
• consciousness can be confused.
• Tachycardia is followed by bradycardia due to swelling and
oedema of brain.

18. DIAGNOSIS
• Blood test- leucocytosis is marked with neutrophilic shift. High
ESR , Eosinophillia
• cerebrospinal fluid (CSF) exam- for liquor test
• Bacteriological examination- The material for analysis is
the mucus from proximal portions of upper respiratory
tract, blood
• Serological test- direct haemagglutination reaction, latex test

20. DIFFERENTIAL DIAGNOSIS
• measles, scarlet fever, rubella, diseases of the blood
(thrombocytopenic purpura Werlgoff’s disease;
hemorrhagic vasculitis – Sheinlein-Henoch’s disease).

21. TREATMENT
• For acute nasopharyngitis: Sulpha drug 4-6 g/day for addults
0.3 g/kg for children- 3-5 dys
For meningitis: Antibiotics (penicillin – 300000 u/kg- 5-8 days for adult
ampicillin- 0.15-0.2 g/kg/day)
Chloramphenicol sodium succinate- 0.05 -0.1 g/kg- 6-8 days

22. • Septic shock managed by infusion of polyion solution(ringer
solution),
5% glucose should be given
by drip
Glucocorticoids( hydrocortisone , prednisolone) should also be
given.
Symptomatic treatment and adequate nutrition are also
necessary.

23. PROPHYLAXIS
• Prophylactic measures,directional on the sources of meningococca
l infection include early revelation of the patients,
• sanation of meningococcal carriers,
isolation and treatment of the patients
• Medical observation is established in the focuses of the infectio
n about contact persons during 10 days.

24. PROPHYLAXIS
• The measures against of the transmissive mechanism,
are concluded in performance of sanitary and hygienic me
asures and disinfection.
• There are several vaccines-
polysaccharide vaccines A and C.