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Meningococcal meningitis is a potentially fatal condition, and a diagnosis should be be made early to avoid potentially life threatening complications.
Caused by viruses and bacteria
Menigitis, or the inflammation and infection of the meninges (the membranes covering the brain and spinal cord), can be caused by viruses and bacteria. Meningococcal meningitis is caused by the bacteria Neisseria meningitidis. This bacterium is responsible for most bacterial meningitis infections in children.
The condition presents with typical meningitis symptoms (as with Boy X) which includes:
- Malaise
- Stiff neck (meningism)
- Sensitivity of eyes to light (photophobia)
- Very high, persistent fever
- Joint pains
- Nausea
- Vomiting
As the condition progresses, a change in behaviour may occur. Severe lethargy, irritability, sweating, and incoherent speaking and thoughts may develop.
With meningococcus, patients usually have a typical rash which may look like bruising. What is very important to watch out for with the rash is that it does not blanch (turns white when pressed on). This is a sign of septicaemia (blood infection).
Diagnosis of the condition is made with proper history taking, clinical examination and laboratory testing. The doctor, on examination, will look for signs of septicaemia, meningism and meningeal irritability.
A lumbar puncture will be performed. Usually, with infection, the crystal clear spinal fluid appears turbid. Direct microscopy and incubation of the spinal fluid will be done. Once the presence of bacteria has been confirmed, the laboratory will do further testing to determine to which antibiotics the organism is sensitive to.
In-hospital antibiotic treatment with supportive symptomatic treatment is the mainstay.
If left untreated, meningococcus meningitis can cause deafness, paralysis, brain damage and even death. If any of the signs of meningitis are present, a doctor should examine the patient to exclude meningitis, and if diagnosed, administer the appropriate treatment.
Vaccines against meningococcal disease are available. These vaccines are of particular importance in central African countries where meningococcus meningitis is common.
NOTE: Health24's on-site GP Dr Owen Wiese reveals new cases on Thursdays. The answer is posted with the story on Mondays, or you can get it in our Daily Tip – sign up here.
Previously on What's Your Diagnosis?
What's your diagnosis - Case 1: vomiting and weight loss
What's your diagnosis - Case 2: eye pain
What's your diagnosis - Case 3: strange behaviour and a bullet in the back
What's your diagnosis - Case 4: seeing odd things
What's your diagnosis - Case 5: mysterious lungs
What's your diagnosis - Case 6: runner with seizures
What's your diagnosis - Case 7: swollen knee
What's your diagnosis - Case 8: bloody semen
What's your diagnosis - Case 9: confusing neurological signs
What's your diagnosis - Case 10: diabetic teenager with unusual signs and symptoms
What's your diagnosis - Case 11:bruising with no apparent cause
What's your diagnosis - Case 12: severe tummy pain
What's your diagnosis - Case 13: severe sore throat
What's your diagnosis - Case 14:abdominal pain and swelling
What's your diagnosis - Case 15: the world is spinning
What's your diagnosis? – Case 16: numbness in forearm
What's your diagnosis? - Case 17: burning urine
What's your diagnosis? – Case 18: boy with persistent fever
What's your diagnosis? – Case 19: lady who can't lose weight
What's your diagnosis? – Case 20: chest pain next to breastbone
What's your diagnosis? – Case 22: vomiting and headaches
Image: Meningitis from Shutterstock
