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What are meningococcal infections?

Meningococcal infections are caused by a group of bacteria called Neisseria meningitidis. The most common forms of meningococcal infections include meningitis (infection of the membranes that surround the brain and spinal cord) and meningococcemia (blood stream infections). Doctors in the Division of Infectious Diseases at Boston Children's Hospital care for children and adolescents with all types of infections, including meningococcal infections.

  • Meningococcal infections are not common and can be serious.
  • About 2,600 cases of invasive meningococcal disease occur in the United States each year.
  • They frequently occur during the late winter and early spring months.
  • Meningococcal infections are most common in children, but also occur in adolescents and adults.
  • Early treatment is essential.
  • They are usually treated with antibiotics, but children may require hospitalization.
  • A vaccine helps prevent meningococcal infections.

What are the types of meningococcal infections?

The most common forms of meningococcal infections include:

  • Meningitis
    • infection of the membranes that surround the brain and spinal cord
  • Meningococcemia
    • a blood stream infection
    • potentially life-threatening
    • symptoms may occur abruptly and progress rapidly
    • immediate intervention and treatment are usually necessary
    • nearly 20 percent of children who develop meningococcemia do not survive

Are meningococcal infections common?

Meningococcal infections are usually uncommon, but potentially fatal. More specifically:

  • The Centers for Disease Control and Prevention (CDC) estimates 2,600 cases of invasive meningococcal disease in the United States each year.
  • They occur most frequently during the late winter and early spring months.
  • They are most common in children, but also occur in adolescents and adults.

Can you prevent meningococcal infections?

The meningococcal vaccine helps prevent most strains of meningococcus bacteria. It is normally given during the routine pre­adolescent immunization visit (when a child is 11 or 12 years old).

Symptoms & Causes

What are the symptoms of meningococcal infections?

While symptoms vary from child-to-child, the most common include:

  • For meningococcal meningitis
    • In infants (symptoms are difficult to pinpoint)
      • irritability
      • sleeping all the time
      • refusing bottle
      • cries when picked up or being held
      • inconsolable crying
      • bulging fontanelle (soft spot on an infants head)
      • behavior changes
    • In children older than one year
      • neck and/or back pain
      • headache
      • nausea and vomiting
      • neck stiffness
  • For meningococcemia
    • fever
    • chills
    • sore throat
    • headache
    • aching muscles and joints
    • exhaustion and weariness
    • rash, which may appear small, red flat or raised, fine at first and then changes to larger red patches or purple lesions similar in appearance to large bruises
    • low blood pressure
    • very low urine output
    • impaired blood clotting that can lead to internal and external bleeding

What causes meningococcal infections?

The Neisseria meningitidis bacteria are spread through close contact with infected people. Droplets in the air from a sneeze or close conversation can be inhaled and may cause infection. In rare cases, the bacteria grow rapidly causing serious illness in both children and adults.

Diagnosis & Treatments

How do we diagnose meningococcal infection?

In addition to a complete medical history and physical exam, your child's doctor may want to perform:

  • A lumbar puncture (spinal tap)
    • special needle is placed into the lower back, into the spinal canal
    • measures the pressure in the spinal canal and brain
    • small amount of cerebral spinal fluid (CSF) can be removed and sent for testing to determine if there is an infection or other problems
    • not be recommended if your child is very ill
  • Blood cultures
    • Culture of skin lesions or rash
    • Additional blood work (to evaluate bleeding times and cell counts)

How do we treat meningococcal infections?

Prompt treatment is imperative with meningococcal infections. Also, if your child is in close contact with a person who has a meningococcal infection, such as a roommate, parent, sibling, daycare worker, classmate, boyfriend or girlfriend, she is at an increased risk and may need antibiotics.

Traditional treatments for meningococcal infections

Treatment for a meningococcal infection usually includes:

  • Antibiotics
    • such as penicillin (if your child is allergic to penicillin, other antibiotics may be used)
    • Five to seven days of antibiotics is usually effective
  • Hospitalization
    • Your child may require close observation in a hospital or intensive care unit (ICU).
    • She will require isolation for 24 hours after antibiotics have been administered.
    • If your child has a severe infection, she may require supplemental oxygen or mechanical ventilation to assist with breathing.
    • If your child develops severe bleeding, she may require blood transfusions.
  • Supportive
    • aimed at relieving symptoms
    • plenty of rest
    • Tylenol for fever or headaches

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The Division of General Pediatrics seeks to enhance the lives of children and families through clinical care, teaching, research, and community service.

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The Department of Neurology cares for infants, children, and adolescents with all types of neurologic and developmental disorders.
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