Meningococcal disease is a serious and potentially life-threatening infection that is caused by the bacterium Neisseria meningitidis (N. meningitidis), and it can cause meningitis, meningococcaemia outbreaks and epidemics. The disease is fatal in 9-12% of cases and with a death rate of up to 40% among patients with meningococcaemia. The objective of this study was to estimate the costs of a men...

Introduction Meningococcal infection may present as meningitis or as acute-fulminating, subacute or chronic sepicaemia. There may be associated arthritis, vasculitis, episcleritis and intravascular coagulation (Whittle et al., 1973). Such complications which usually occur between 3 and 10 days from the onset of the illness, when patients are otherwise improving, have been attributed to immune c...

A 17-year-old girl presented with Neisseria meningitidis sepsis, with evidence of disseminated intravascular coagulation. Substitution therapy with both antithrombin and protein C concentrates was initiated, leading to clinical and biological improvement. Sequential dosages were performed for biological markers including thrombin-activatable fibrinolysis inhibitor (TAFI). Substitution therapy w...

Extrameningeal complications of meningococcal septicaemia occur in about 11–19% of cases, and include myocarditis, acute renal failure, arthritis, pneumonia, skin gangrene, conjunctivitis, endocarditis, pericarditis, endophthalmitis, urethritis, WaterhouseFriderichsen syndrome, vasculitis, and digital ischaemia. We describe the use of a prostacyclin analogue in the treatment of cutaneous digita...

Coagulation in Meningococcal Infection Sir, The description by Fox in the recent issue of the Archives (October 1971) of histological evidence of widespread intravascular coagulation in 13 patients dying of the Waterhouse-Friderichsen syndrome (with proved meningococcal septicaemia in two) and his suggestion that heparin should be used in such patients, prompts us to report the following patient:-

Mortality among patients suffering from meningococcal septicaemia has reached nearly 50% in parts of northern Norway despite intensive care. The activation of complement and blood cells by endotoxin is assumed to be the cause of most of the associated pathophysiological changes. Consequently, it would seem logical to remove such constituents either by combined plasmapheresis and leucapheresis o...

Antibodies to Escherichia coli J5, a uridine 5'-diphosphate-galactose epimerase-less mutant of E. coli 0111, neutralized meningococcal endotoxemia from all three major capsular serogroups. We chose the dermal necrosis of the local Shwartzman phenomenon and the renal cortical necrosis of the general Shwartzman phenomenon as assays because these are the hallmarks of meningococcemia, and because m...