| Abstract [eng] |
Backround: Meningococcal infection is a leading cause of preventable death and disability in both developed and developing countries. The most dangerous form of this disease is fulminant meningococcal sepsis. An extremely dangerous and acute disease that causes difficulties for the medical staff both in diagnosing and treating it. This work reviews the clinical case, disease epidemiology, pathophysiology, clinical presentation, diagnostic difficulties, treatment methods, prophylaxis, prevention and prognosis. Methods: One clinical case of fulminant meningococcemia was described and the literature research was made using „PubMed“ and „Google Scholar“ databases using the following keywords: „Neisseria meningitidis“, „meningococcal disease“, „meningococcemia“. In all, 61 articles were used to write this manuscript. Results: About one in ten people is a carrier of Neisseria meningitidis, but the invasive form of the disease is rear, the incidence in Europe in 2021 was 0.1 case per 100 000 per year. Meningococcus typically colonize the nasopharynx, after invading the bloodstream and persisting in the body a clinically significant form of the disease occurs. A major virulence factor characteristic of this strain is endotoxin secretion, leading to an increase in cytokine concentrations and a cytokine storm. The typical well-known symptoms of the disease include fever, purplish skin rash, muscle stiffness and headache. However, the disease often manifests atypically and causes difficulties in diagnosis. The most important thing in treatment is early suspicion and the appointment of antibacterial treatment (ceftriaxone or cefotaxime). Despite improving treatment methods, mortality from fulminant meningococcal infection ranges from 20% to 80%. Without timely diagnosis and treatment, death can occur within 12 hours from the patient’s referral to the hospital. Chemoprophylaxis is recommended for people who have had contact with the sick person. The best prevention is vaccinations, which are recommended for all age groups depending on the geographic location. This infection is also characterized by various long-term complications, from scars due to tissue necrosis to deafness and limb amputations. Conclusions: Early suspicion of fulminant meningococcal sepsis and appropriate antibiotic therapy can save the patient's life. The most effective and only rational approach to the prevention of this dangerous infection is through vaccination. |
