Meningococcal infection

Bilateral adrenal hemorrhage or infarction—usually due to anticoagulant therapy, coagulopathy, thromboembolic disease, or meningococcal infection. Causes acute adrenal insufficiency. 

Neisseria meningitidis carriers Treatment of asymptomatic carriers of N. meningitidis to eliminate meningococci from the nasopharynx. Not indicated for treatment of meningococcal infection. 

Streptococcal infections Pharyngitis, rheumatic fever, otitis media and even for subacute bacterial endocarditis. Staphylococcal infections Penicillinase resistant penicillin can be used. Meningococcal infections Meningitis other infections caused by meningococci. 

Penicillin G Prevents bacterial cell wall synthesis by binding to and inhibiting cell wall transpeptidases Rapid bactericidal activity against susceptible bacteria Streptococcal infections, meningococcal infections, neurosyphilis IV administration rapid renal clearance (half-life 30 min, so requires frequent dosing (every 4 h) Toxicity Immediate hypersensitivity, rash, seizures... 

Meningococcal infection Close contacts of a case Rifampin, ciprofloxacin, or ceftriaxone Excellent... 

The liver is the primary source of several components of the complement system (i.e., C2, C3, C4, and factors B and D) therefore, in severe liver failure, a global decrease in complement factors occurs. Inherited complement deflciencies have been described in patients with systemic lupus erythematosus, autoimmune diseases, recurrent gonococcal and meningococcal infections, membranopro-liferative glomerulonephritis, and hereditary angioedema. ... 

Schwartz B. Chemoprophylaxis for bacterial infections Principles of and appUcation to meningococcal infections. Rev Infect Dis 1991 13(suppl 2) S170-173. 

Figure 3 Structures of the two alternative a chains of meningococcal LOS. The residnes are attached in seqnence by the transferases as shown. Transferases encoded by the IgtA, IgtC, and IgtD genes contain the poly-G tracts and are responsible for the phase variation in LOS. In fact, structure II is made only if IgtA is inactive. At certain stages of meningococcal infections, the chain may further be sialylated.

Despite this setback, the pharmaceutical industry was encouraged to prepare literally hundreds of sulfonamides, of which May and Baker 693 (sul-fapyridine) proved to be the most potent and broad spectrum. It also achieved star status once it was revealed that it had been used to save the life of Winston Churchill when he contracted pneumonia during a visit to North Africa in December 1943. Other sulfonamides that have been widely prescribed are sulfadiazine, sulfadimidine (especially for urinary tract infections and meningitis caused by meningococcal infections) and sulfamethoxazole. One problem with many sulfonamides is their relative water insolubility and their tendency to crystallise in the kidney tubules. They are also metabolised via acetylation of the aniline nitrogen, and these metabolites are both inactive and less soluble. 

Figure 7. Meningococcal infections Notifications and percentage rate of deaths, 1931 to 1961...

Examples of common clinical situations in which nonsurgical antimicrobial prophylaxis is effective are given in Table 51-4. Nonsurgical prophylaxis, mentioned in earlier chapters, includes the prevention of CMV and HIV infections, influenza, meningococcal infections, and tuberculosis. Though somewhat less effective, antimicrobial prophylaxis is also commonly used for animal or human bite wounds and chronic bronchitis. Severely leukopenic patients are often given prophylactic antibiotics. 

Ampicillin is essentially equivalent to benzylpenicillin for pneumococcal, streptococcal, and meningococcal infections, and many strains of Gram-negative Salmonella, Shigella, Proteus mirabllls, and Escherichia coll, as well as many strains of Haemophilus influenzae and Neisseria gonorrhoeae, respond well to oral treatment with ampicillin. 

Thomas L, Din e JH. Investigations of meningococcal infection. III. Bactericidal action of normal and immune sera for the meningococcus. J Clin Invest 1943 22 375-385. 

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