Neisseria meningitidis: Difference between revisions
From IDWiki
Neisseria meningitidis
No edit summary |
(→) |
||
| Line 14: | Line 14: | ||
*In African meningitis belt, serogroups A, C, W-135, and X are most common |
*In African meningitis belt, serogroups A, C, W-135, and X are most common |
||
| − | === |
+ | ===Risk Factors=== |
| − | * |
+ | *Living in African meningitis belt during an epidemic |
| − | * |
+ | *Participating in Hajj pilgrimage |
| − | * |
+ | *Living in student dormitories |
| − | * |
+ | *Living in military barracks |
| − | == |
+ | ==Clinical Manifestations== |
| − | * |
+ | *Causes [[Causes::bacterial meningitis]] |
| − | * |
+ | *May have petechial or purpuric rash |
| − | == |
+ | ==Management== |
| − | * |
+ | *For meningitis: [[Is treated by::ceftriaxone]] 2 g IV q12h or [[Is treated by::penicillin G]] for 7 days (5 days in UK) |
| − | ** |
+ | **Alternatives include [[chloramphenicol]], [[aztreonam]], and [[meropenem]] |
| − | == |
+ | ==Prevention== |
| − | * |
+ | *Chemoprophylaxis of close contacts is indicated to prevent disease regardless of immunization status |
| + | **Close contacts include: household contacts; people who share sleeping arrangements; people who have direct contamination of nose or mouth with the case; children and childcare staff; airline passengers sitting immediately to the left and right if flight was at least 8 hours |
||
| − | * Close contacts include living in same household, kissing, or being exposed during resuscitation within 7 days |
||
| + | **Not usually for healthcare contacts, unless intensive unprotected contact such as intubation or resuscitation without PPE |
||
| − | * Treat with [[ciprofloxacin]] one dose, within 24 hours of exposure |
||
| + | **Exposures within 7 days before symptoms to 24 hours after appropriate antibiotics |
||
| + | **Ideally within 24 hours, but up to 10 days (end of incubation period) after last contact with the case |
||
| + | *Choice of chemoprophylaxis |
||
| + | **For adults: [[ciprofloxacin]] 500 mg PO once or [[rifampin]] 600 mg PO q12h for four doses |
||
| + | **For children: [[rifampin]] 5 mg/kg (<1 month) to 10 mg/kg (≥1 month, max 600 mg) PO q12h for 4 doses |
||
| + | **Alternative: [[ceftriaxone]] 125 mg (<12 years) to 250 mg (≥12 years) IM once |
||
| + | *Also vaccination, for all close contacts except airplane and healthcare |
||
{{DISPLAYTITLE:''Neisseria meningitidis''}} |
{{DISPLAYTITLE:''Neisseria meningitidis''}} |
||
[[Category:Gram-negative cocci]] |
[[Category:Gram-negative cocci]] |
||
Revision as of 11:56, 15 September 2020
Background
Microbiology
- Gram-negative diplococcus
- Traditionally organized by serogroups of capsular polysaccharide
- A, B, C, E, H, I/K, L/ W, X, Y, and Z are confirmed genetically
Epidemiology
- Six serogroups cause essentially all disease: A, B, C, W, X, and Y
- In Canada, serogroups B, C, W-135 and Y are the most common causes, with B being the most commonly reported
- Historically, B caused the majority of sporadic cases, and virulent serogroup C caused the majority of outbreaks
- In African meningitis belt, serogroups A, C, W-135, and X are most common
Risk Factors
- Living in African meningitis belt during an epidemic
- Participating in Hajj pilgrimage
- Living in student dormitories
- Living in military barracks
Clinical Manifestations
- Causes bacterial meningitis
- May have petechial or purpuric rash
Management
- For meningitis: ceftriaxone 2 g IV q12h or penicillin G for 7 days (5 days in UK)
- Alternatives include chloramphenicol, aztreonam, and meropenem
Prevention
- Chemoprophylaxis of close contacts is indicated to prevent disease regardless of immunization status
- Close contacts include: household contacts; people who share sleeping arrangements; people who have direct contamination of nose or mouth with the case; children and childcare staff; airline passengers sitting immediately to the left and right if flight was at least 8 hours
- Not usually for healthcare contacts, unless intensive unprotected contact such as intubation or resuscitation without PPE
- Exposures within 7 days before symptoms to 24 hours after appropriate antibiotics
- Ideally within 24 hours, but up to 10 days (end of incubation period) after last contact with the case
- Choice of chemoprophylaxis
- For adults: ciprofloxacin 500 mg PO once or rifampin 600 mg PO q12h for four doses
- For children: rifampin 5 mg/kg (<1 month) to 10 mg/kg (≥1 month, max 600 mg) PO q12h for 4 doses
- Alternative: ceftriaxone 125 mg (<12 years) to 250 mg (≥12 years) IM once
- Also vaccination, for all close contacts except airplane and healthcare
References
- ^ Charles Feldman, Ronald Anderson. Meningococcal pneumonia: a review. Pneumonia. 2019;11(1). doi:10.1186/s41479-019-0062-0.
