Meningococcal bacteremia
Introduction
Introduction to meningococcalemia Meningococcalemia is a sepsis caused by meningococcus, the skin is characterized by ecchymosis, pathological manifestations of vascular endothelium damage, vascular wall inflammation and necrosis and thrombosis, and perivascular hemorrhage, and subcutaneous mucosa and Focal membrane and other focal hemorrhage, causing meningococcal disease of the disease, is a negative stain of Neisseria Gram, mainly in the nasopharynx usually infected by droplets of patients or carriers, more common in children under 10 years old child. Adults can also develop the disease during the hot season, and the winter and spring seasons are good seasons. basic knowledge The proportion of sickness: 0.01% Susceptible people: more common in children under 10 years of age. Mode of infection: droplet infection of the patient or carrier. Complications: sepsis, herpes simplex
Cause
Causes of meningococcalemia
(1) Causes of the disease
Neisseria meningitidis caused by this disease, Gram-negative, mainly in the nasopharynx, usually caused by droplets of patients or carriers, more common in children under 10 years old, adults in the popular season can also Onset, winter and spring are good seasons.
(two) pathogenesis
Meningococcal invasive blood circulation causes sepsis, skin manifests as ecchymosis, pathological manifestations of vascular endothelium damage, inflammation of the vessel wall, necrosis and thrombosis, and perivascular hemorrhage, and skin, subcutaneous, mucosal and serosal Such as focal bleeding.
Prevention
Meningococcalemia prevention
1. Do a good job in publicity during the epidemic, pay attention to personal environmental sanitation, early detection of early treatment, early isolation, injection of meningococcal vaccine, drug prevention.
2. Pay attention to skin hygiene, strengthen physical exercise and increase resistance.
3. Maintain the integrity of skin function. For skin diseases, especially pruritic skin diseases, timely treatment should be carried out to prevent skin damage and avoid irritation such as scratching and skin friction.
4. Clothes, towels, basins, etc. are prohibited from public use to prevent contact with infection. The patient should be properly isolated. The dressings and contact materials used by the patient should be strictly disinfected or burned. During the illness, it is forbidden to use the liquid to clean the skin lesions. Wash the affected area with tap water to prevent extension.
5. When you are sick, you should ban alcohol or spicy food, and eat less food.
Complication
Complications of meningococcalemia Complications sepsis herpes simplex
About 10% of patients with common sepsis can develop herpes simplex around the lips or other parts about 2 days after onset. Herpes simplex is a viral skin disease caused by human herpes simplex virus. The motherland medicine is called hot sore. Occurs at the junction of the skin and mucous membranes, such as the pharynx, the lips, the eyelids and the external genitalia. It is characterized by conscious itching or burning sensation; the rash is a densely integrated group, the tip of the blister, forming a shallow ulcer after rupture; the skin lesions occur at the junction of the skin and mucous membranes, such as the mouth, lips, eyelids and external genitals.
Symptom
Symptoms of meningococcal disease Common symptoms Septic plaque erythema rash skin herpes herpes nodules meningitis bacteremia pustules
Since there are various types of meningococcal sepsis, the skin lesions are also diverse.
1. Ordinary sepsis rash can be seen in about 70% of patients, appear shortly after the disease, mainly for sputum and ecchymosis, found in the skin and mucous membranes, the size is 1mm ~ 1cm, sputum, spotted before the appearance of ecchymosis Systemic rose plaque, the disease is severe, the ecchymosis can be rapidly expanded, and the skin is necrotic due to thrombosis. In addition, herpes and pustules are still visible, about 10% of patients are about 2 days after onset, lip Herpes simplex can occur in the week or elsewhere.
2. Explosive septicemia often occurs in the short-term (12h) throughout the body, extensive acne, ecchymosis, and rapidly expand into a large subcutaneous hemorrhage or followed by necrosis.
3. Chronic meningitis, double-cell septicemia, fever often occurs in groups of rashes, red rash is the most common, sputum, subcutaneous hemorrhage, pustules can also be seen, sometimes visible nodular erythematous rash, center may have bleeding, rash more Found in the limbs, the rash also receded after the fever subsided.
Examine
Examination of meningococcalemia
Histopathology: The main lesions in the sepsis period are vascular endothelium damage, inflammation of the blood vessel wall, necrosis and thrombosis, and perivascular hemorrhage, and focal bleeding such as skin, subcutaneous, mucosa and serosa.
A large number of Gram-negative diplococcus can be found in the skin vascular endothelial cells and in the cavity. The visceral vascular damage of the skin is more serious and extensive, with endothelial cell destruction and shedding, and fibrin-white blood cells-platelets in the blood vessels. thrombus.
In the chronic phase, more lymphocytes infiltrated around the blood vessels, and fewer neutrophils. In addition to bleeding in the sputum area, more neutrophils were seen.
Diagnosis
Diagnosis and differentiation of meningococcalemia
The diagnosis of meningococcal culture from the patient's cerebrospinal fluid or blood is immediately established, and a positive result can be obtained by taking a blood smear test in early ecchymosis.
