1. Department of Infectious Diseases ( Shi Hong ) MENINGOCOCCAL MENINGITIS

2. Meningococcal meningitis Meningococcal meningitis Morbidity mortality rate Morbidity mortality ● early diagnosis ● modern therapy ● supportive measure HIGH low

13. Clinical manifestations What are the signs and symptoms petechia in the skin (Meningococcal meningitis)

15. Clinical manifestations Meningococcal meningitis Septic period ▲ an abrupt onset ▲ chills high fever ▲ Headache ▲ Petechias ▲ purpuras ▲ Splenomegaly Meningitic period ▲ intracranial pressure ▲ headache ▲ vomiting ▲ restlessness ▲ Stiff neck ▲ Kernig (+) ▲ brudziski (+) ▲ gradually disappears , ▲ recovers to normal . Prodromal period Septic period Meningitic period Convalescent period

16. Clinical manifestations Meningococcal meningitis

17. Clinical manifestations Meningococcal meningitis

22. Laboratory examination Meningococcal meningitis Figure : Neisseria meningitidis Gram-stain of a pure culture

26. Problems To analyze the case what’s the most likely diagnosis? 1 what do we still do for definitive diagnosis? 2 How to treat this young patient? 3

28. Treatment Meningococcal meningitis ⑴ Shock type ① Etiology treatment: . Penicillin G ② Shock should be corrected promptly: a. Volume expanded. b. Metabolic acidosis corrected. c. Vasoactive drugs. d. Adrenal corticosteroids. e. Important organs protected Fulminate type ⑵ Meningococcemia-meningitis type ① Effective antibacterial drugs. Penicillin G. ② Alleviate cerebral edema Mannitol and 50 per cent Glucose. ③ Adrenal corticosteroids: Dexamethasone ④ Treatment in respiratory failure: lobeline, coramine ⑤ High fever and seizure: Sedatives: wintermine phenergan

29. Prognosis Meningococcal meningitis Fulminate meningo-coccemia early diagnosed appropriately treated in the extremes of age Good poor poor

30. Prevention Meningococcal meningitis Protect Protection of the susceptible population Protect Protection of the susceptible population Administer meningococcal vaccines, Chemoprophylaxis isolate for 3 days after the symptoms disappeared, generally no less 7 days after the onset observe Close contacts: observed medically for 7 days . Disrupt To go to the crowd places should be avoided during the epidemic

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