Neisseria meningitidis: Difference between revisions
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Neisseria meningitidis
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*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 |
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===Risk Factors=== |
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*Living in African meningitis belt during an epidemic |
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*Participating in Hajj pilgrimage |
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*Living in student dormitories |
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*Living in military barracks |
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==Clinical Manifestations== |
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*Causes [[Causes::bacterial meningitis]] |
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*May have petechial or purpuric rash |
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==Management== |
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*For meningitis: [[Is treated by::ceftriaxone]] 2 g IV q12h or [[Is treated by::penicillin G]] for 7 days (5 days in UK) |
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**Alternatives include [[chloramphenicol]], [[aztreonam]], and [[meropenem]] |
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==Prevention== |
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*Chemoprophylaxis of close contacts is indicated to prevent disease regardless of immunization status |
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**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 |
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* Close contacts include living in same household, kissing, or being exposed during resuscitation within 7 days |
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**Not usually for healthcare contacts, unless intensive unprotected contact such as intubation or resuscitation without PPE |
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* Treat with [[ciprofloxacin]] one dose, within 24 hours of exposure |
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**Exposures within 7 days before symptoms to 24 hours after appropriate antibiotics |
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**Ideally within 24 hours, but up to 10 days (end of incubation period) after last contact with the case |
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*Choice of chemoprophylaxis |
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**For adults: [[ciprofloxacin]] 500 mg PO once or [[rifampin]] 600 mg PO q12h for four doses |
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**For children: [[rifampin]] 5 mg/kg (<1 month) to 10 mg/kg (≥1 month, max 600 mg) PO q12h for 4 doses |
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**Alternative: [[ceftriaxone]] 125 mg (<12 years) to 250 mg (≥12 years) IM once |
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*Also vaccination, for all close contacts except airplane and healthcare |
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{{DISPLAYTITLE:''Neisseria meningitidis''}} |
{{DISPLAYTITLE:''Neisseria meningitidis''}} |
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[[Category:Gram-negative cocci]] |
[[Category:Gram-negative cocci]] |
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Revision as of 15:56, 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.
