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Meningococcemia in an 11 Months Old Infant
Rachana Shrestha1, Saurab Karki2, Manoj Khadka3
1Department of Pediatrics, Shree Birendra Hospital, Kathmandu, Nepal.
Abstract:
Meningococcemia is the infection of the blood caused by Neisseria meningitidis. Herein, we report a case of meningococcemia in an 11 months old infant who had a high-grade fever, nonblanching purpuric rash over the face and limbs, low blood pressure, tachycardia, and prolonged capillary refill time, but without neck rigidity and focal neurologic signs. He recovered after supportive care and treatment with antibiotics (intravenous ceftriaxone, vancomycin, and teicoplanin). Therefore, in a febrile, ill-looking child in shock with a nonblanching rash, meningococcal disease should be suspected. The study shows the importance of vaccination against meningococcal disease.
Insights
Meningococcemia, a serious blood infection caused by Neisseria meningitidis, can present in infants with fever and rash without typical meningitis signs. Early suspicion and treatment are crucial for recovery and highlight the importance of meningococcal vaccination.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Meningococcemia is a severe bloodstream infection caused by Neisseria meningitidis.
- Early recognition and prompt treatment are critical for patient survival.
Observation:
- An 11-month-old infant presented with high-grade fever, a nonblanching purpuric rash, hypotension, tachycardia, and prolonged capillary refill time.
- The infant lacked typical signs of meningitis such as neck rigidity and focal neurologic deficits.
Findings:
- The infant recovered following supportive care and broad-spectrum antibiotic treatment, including intravenous ceftriaxone, vancomycin, and teicoplanin.
- This case underscores that meningococcal disease can manifest without classic meningeal signs.
Implications:
- Clinicians should suspect meningococcal disease in febrile infants presenting with shock and a nonblanching rash, even without neck stiffness.
- The findings emphasize the critical role of meningococcal vaccination in preventing severe disease and its complications.
