Neisseria meningitidis accounted for over half the 2,360 notified cases of meningitis in England and Wales in 19971 and is the leading infectious cause of death in childhood2–4. There were twice as many notifications of meningococcal disease in 1997 as in 1994 and the mortality remained at around 10% (ca 240 deaths)1,2. This article focuses on the presentation and management of meningococcal di...

An atypical presentation of meningococcaemia without purpura poses diagnostic problems. The importance of the identification of shock manifest as delayed capillary refill in two children with meningococcal septicaemia presenting with fever and abdominal pain is discussed. Abdominal pain is an unusual presentation of meningococcal disease.

Activated protein C (APC) is a natural anticoagulant that plays a pivotal role in coagulation homeostasis. Severe inherited or acquired deficiency results in a clinical syndrome called purpura fulminans. In addition, APC also appears to have potent cytokine-modifying properties and is protective in animal models of sepsis. The dual functional properties of APC are particularly relevant to sever...

Between March and May of 2011, a cluster of three fatal cases of meningococcal sepsis occurred in Andalusia, Spain, in a municipality with a population of around 20,000 inhabitants. The cases were in their mid-teens to early thirties and were notified to the epidemiological surveillance system of Andalusia (Sistema de Vigilancia Epidemiológica de Andalucía, SVEA) during a 68-day period from Mar...

We are presenting a case of isolated fulminant meningococcal sepsis with two and a half year old child. Initial symptoms were obscure and common to many medical conditions, but also previously described as symptoms of meningococcal sepsis. Unrecognizing the seriousness of the condition child died at home, within few hours after examination and discharge from the hospital. Autopsy and microbiolo...

Invasive meningococcal disease is a serious life-threatening infection. Skin rash is present in about half of the patients with meningococcal infection. However it could be easily missed if no thorough cutaneous examination is performed. Herein, we present a patient with invasive meningococcal serogroup B infection with diffuse cutaneous purplish rash and ecchymoses, suggestive of purpura fulmi...

Herein, we present a case of meningococcal disease in a patient presenting with of a three-week history of fever, cutaneous vasculitis and joint pain, in whom chronic meningococcemia was retained as presumptive diagnosis, after the disease evolved towards meningitis. This unusual case illustrates the great heterogeneity in possible clinical presentations of Neisseria meningitidis infections and...

The inhibitory and bactericidal effects of sodium polyanetholesulfonate on Neisseria meningitidis were neutralized by blood lysis which occurs within the pediatric Isolator 1.5 Microbial tube (E. I. du Pont de Nemours & Co., Inc., Wilmington, Del.). Lysed blood was more effective than 2.5% gelatin in preventing the inhibitory effect. All but 1 of 16 N. meningitidis strains were killed by 0.06% ...