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Meningococcal sepsis

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https://www.readbyqxmd.com/read/28915308/mutilating-purpura-fulminans-in-an-adult-with-meningococcal-sepsis
#1
María Elena Arnáiz-García, Ana María Arnáiz-García, Francisco Gutierrez-Diez, Juan Francisco Nistal, Jose María González-Santos, Ivana Pulitani, Carlos Amado-Diago, Javier Arnáiz
We report a dramatic case of meningococcal sepsis manifesting as purpura fulminans in an elderly diabetic woman. Hemodynamic instability and severe bilateral cutaneous lesions involving her hands and feet developed rapidly. Specific antibiotic therapy and the administration of inotropic and vasopressor drugs were initiated. The severity and extension of the cutaneous lesions (attributed to purpura fulminans) worsened because of the need for vasoconstrictors for the treatment of septic shock. Bilateral transmetatarsal and metacarpal amputations were required to stabilize the patient...
September 2017: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/28776217/neck-injury-and-conjunctival-petechiae-in-a-woman-who-underwent-cardiopulmonary-resuscitation-and-subsequently-died-from-meningococcal-sepsis
#2
Jack Garland, Rexson Tse
Cardiopulmonary resuscitation (CPR) can create a range of unusual lesions and injuries, which may complicate forensic evaluation. Although potentially sinister findings, neck injury and conjunctival petechiae may also be seen in patients who have undergone CPR. We report a case of an individual with subcutaneous bruising and hemorrhage in the deep structures of the neck and florid conjunctival petechiae at autopsy that can be explained by cardiopulmonary resuscitation and meningococcal sepsis.
August 3, 2017: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/28745253/-gastrointestinal-symptoms-with-meningococcal-infection-emergence-of-neisseria-meningitidis-serogroup-w
#3
H F Wunderink, I N Vlasveld, M J Knol, A van der Ende, E H R van Essen, E J Kuijper
BACKGROUND: Meningococcal disease usually presents as meningitis and/or septicaemia, but can also present as pneumonia or arthritis. Since 2000, a worldwide increase in meningococcal disease is reported which is caused by a new virulent clone of serogroup W (MenW:cc11). This subtype is more likely to give an atypical clinical presentation and results in high mortality rates. CASE DESCRIPTION: A 68-year-old woman with polymyalgia rheumatica, managed with prednisone, developed an acute gastrointestinal syndrome of nausea, diarrhoea, vomiting, fever and chills...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28739825/neisseria-cinerea-expresses-a-functional-factor-h-binding-protein-which-is-recognised-by-immune-responses-elicited-by-meningococcal-vaccines
#4
Hayley Lavender, Katy Poncin, Christoph M Tang
Neisseria meningitidis is a major cause of bacterial meningitis and sepsis worldwide. Capsular polysaccharide vaccines are available against meningococcal serogroups A, C, W and Y. More recently two protein based vaccines, Bexsero® and Trumenba®, have been licenced against meningococcal serogroup B strains; both vaccines contain meningococcal factor H binding protein (fHbp). fHbp is a surface exposed lipoprotein which binds the negative complement regulator, complement factor H (CFH), thereby inhibiting the alternative pathway of complement activation...
July 24, 2017: Infection and Immunity
https://www.readbyqxmd.com/read/28728477/increased-rate-of-penicillin-non-susceptible-strains-of-n-meningitidis-in-naples-italy
#5
Giovanni Di Caprio, Novella Carannante, Mariano Bernardo, Susanna Cuccurullo, Carlo Pallotto, Carlo Tascini
Neisseria meningitidis is a causative agent of community-acquired sepsis and meningitis in humans. These diseases are associated with high mortality and morbidity if treatment is not started promptly. The empiric antibiotic treatment depends on patient factors and local epidemiology. In the past years, an increased number meningococcal strain with reduced susceptibility to penicillin has also been described. We analysed the susceptibility pattern of 11 N. meningitidis strains isolated between 2013 and 2016...
July 20, 2017: Journal of Chemotherapy
https://www.readbyqxmd.com/read/28633281/the-sweet-side-of-the-pathogenic-neisseria-the-role-of-glycan-interactions-in-colonisation-and-disease
#6
Tsitsi D Mubaiwa, Evgeny A Semchenko, Lauren E Hartley-Tassell, Christopher J Day, Michael P Jennings, Kate L Seib
Glycomics is a rapidly growing field that focuses on the structure and function of carbohydrates (glycans) in biological systems. Glycan interactions play a major role in infectious disease, at all stages of colonisation and disease progression. Neisseria meningitidis, the cause of meningococcal sepsis and meningitis, and Neisseria gonorrhoeae, which causes the sexually transmitted infection gonorrhoea, are responsible for significant morbidity and mortality worldwide. Neisseria meningitidis displays a range of surface glycosylations including capsule polysaccharide, lipooligosaccharide and O-linked glycoproteins...
July 31, 2017: Pathogens and Disease
https://www.readbyqxmd.com/read/28459837/predicted-strain-coverage-of-a-meningococcal-multicomponent-vaccine-4cmenb-in-portugal
#7
Maria João Simões, Célia Bettencourt, Rosita De Paola, Maria Giuliani, Mariagrazia Pizza, Monica Moschioni, Jorge Machado
OBJECTIVE: Although the incidence of meningococcal disease has been declining over the past decade in Portugal MenB meningococci is still an important cause of meningitis and sepsis. The aim of this study was to estimate the strain coverage of the 4CMenB vaccine in Portugal in order to support health policies for prevention and control of meningococcal disease. METHODS: Since 2002 the clinical and laboratory notification of meningococcal disease is mandatory in Portugal...
2017: PloS One
https://www.readbyqxmd.com/read/28368526/discordant-effects-of-licensed-meningococcal-serogroup-b-vaccination-on-invasive-disease-and-nasal-colonization-in-a-humanized-mouse-model
#8
Carolyn M Buckwalter, Elissa G Currie, Raymond S W Tsang, Scott D Gray-Owen
Background.: The multicomponent meningococcal serogroup B vaccine (4CMenB) is an outer membrane vesicle and recombinant protein-based vaccine licensed to protect against serogroup B meningococcal disease. It remains unknown whether this vaccine will prevent carriage or transmission, key aspects in long-term vaccine success and disease eradication. Methods.: Using a "humanized" transgenic mouse model of nasal colonization, we took a systematic approach to estimate the potential for carriage prevention against antigenically diverse Neisseria meningitidis strains and to compare this protection to an invasive meningococcal disease challenge model...
May 15, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28367343/meningococcal-neonatal-purulent-conjunctivitis-sepsis-and-asymptomatic-carriage-of-n-meningitidis-in-mother-s-vagina-and-both-parents-nasopharynx
#9
Enrique Chacon-Cruz, Jorge Arturo Alvelais-Palacios, Jaime Alfonso Rodriguez-Valencia, Erika Zoe Lopatynsky-Reyes, Maria Luisa Volker-Soberanes, Rosa Maria Rivas-Landeros
Neonatal conjunctivitis is usually associated with vagina's infection by Chlamydia sp., N. gonorrhoeae, and/or other bacteria during delivery. Meningococcal neonatal conjunctivitis is an extremely rare disease. We report a case of neonatal meningococcal sepsis/conjunctivitis and asymptomatic carriage of N. meningitidis from both parents (vagina and nasopharynx). As part of our active surveillance for meningococcal disease at the Tijuana General Hospital (TGH), Mexico, we identified a 3-day-old newborn with meningococcal conjunctivitis and sepsis...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28348753/delayed-recognition-of-fatal-invasive-meningococcal-disease-in-adults
#10
Frederick W Nagel, Ifeoma Ezeoke, Mike Antwi, Paula E Del Rosso, Marie Dorsinville, Beth M Isaac, Althea Hayden, Robert S Hoffman, Scott D Weingart, Don Weiss
INTRODUCTION: Invasive meningococcal disease can be difficult to detect early in its course when patients may appear well and the severity of their illness is obscured by non-specific complaints. CASE PRESENTATION: We report five cases of meningococcal sepsis in adult patients who presented to an emergency department early in the course of their disease, but whose severity of illness was not recognized. CONCLUSION: Suspicion of meningococcal sepsis should be heightened in the setting of hypotension, tachycardia, elevated shock index, leukopaenia with left shift, thrombocytopaenia and hypokalaemia, prompting early sepsis care...
June 2016: JMM Case Reports
https://www.readbyqxmd.com/read/28320835/genetic-analysis-of-neisseria-meningitidis-sequence-type-7-serogroup-x-originating-from-serogroup-a
#11
Bingqing Zhu, Pingping Yao, Leyi Zhang, Yuan Gao, Li Xu, Na Xie, Zhujun Shao
Neisseria meningitidis causes meningococcal disease, often resulting in fulminant meningitis, sepsis, and death. Vaccination programs have been developed to prevent infection of this pathogen, but serogroup replacement is a problem. Capsular switching has been an important survival mechanism for N. meningitidis, allowing the organism to evolve in the present vaccine era. However, related mechanisms have not been completely elucidated. Genetic analysis of capsular switching between diverse serogroups would help further our understanding of this pathogen...
June 2017: Infection and Immunity
https://www.readbyqxmd.com/read/28290948/mortality-surveillance-for-infectious-diseases-in-the-u-s-department-of-defense-1998-2013
#12
Robert N Potter, Ladd A Tremaine, Joel C Gaydos
INTRODUCTION: The Mortality Surveillance Division (MSD) of the U.S. Armed Forces Medical Examiner System was established in 1998 to improve surveillance for all military deaths although emphasizing deaths from infectious diseases. Establishment of the MSD was part of the 1997 Department of Defense initiative to improve surveillance and response for emerging infectious diseases. Before 1998, mortality surveillance was limited to compiling information from death certificates, a system that provided limited useful information and lacked the timeliness needed to take meaningful action to address emerging infectious disease threats...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28261486/combined-inhibition-of-c5-and-cd14-efficiently-attenuated-the-inflammatory-response-in-a-porcine-model-of-meningococcal-sepsis
#13
Bernt C Hellerud, Hilde L Orrem, Knut Dybwik, Søren E Pischke, Andreas Baratt-Due, Albert Castellheim, Hilde Fure, Grethe Bergseth, Dorte Christiansen, Miles A Nunn, Terje Espevik, Corinna Lau, Petter Brandtzæg, Erik W Nielsen, Tom E Mollnes
BACKGROUND: Fulminant meningococcal sepsis, characterized by overwhelming innate immune activation, mostly affects young people and causes high mortality. This study aimed to investigate the effect of targeting two key molecules of innate immunity, complement component C5, and co-receptor CD14 in the Toll-like receptor system, on the inflammatory response in meningococcal sepsis. METHODS: Meningococcal sepsis was simulated by continuous intravenous infusion of an escalating dose of heat-inactivated Neisseria meningitidis administered over 3 h...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28120645/neisseria-meningitidis-serogroup-c-sepsis-and-septic-arthritis-in-an-hiv-positive-man
#14
A Fox-Lewis, C P Eades, J J Manson, S Morris-Jones, R F Miller
A patient with well-controlled HIV-1 infection presented with fever and rigors, a widespread maculopapular rash, and severe generalised arthralgia. Sepsis of unknown aetiology was diagnosed, and treatment with broad-spectrum antimicrobials commenced. Following initial clinical improvement, a right knee septic arthritis developed. Microscopy and culture of the joint aspirate were negative for organisms but 16S rDNA PCR identified Neisseria meningitidis DNA, subsequently verified as capsular genogroup C, thus confirming a diagnosis of disseminated meningococcal sepsis with secondary septic arthritis...
January 1, 2017: International Journal of STD & AIDS
https://www.readbyqxmd.com/read/28081260/comparative-genome-sequencing-reveals-within-host-genetic-changes-in-neisseria-meningitidis-during-invasive-disease
#15
COMPARATIVE STUDY
Johanna Klughammer, Marcus Dittrich, Jochen Blom, Vera Mitesser, Ulrich Vogel, Matthias Frosch, Alexander Goesmann, Tobias Müller, Christoph Schoen
Some members of the physiological human microbiome occasionally cause life-threatening disease even in immunocompetent individuals. A prime example of such a commensal pathogen is Neisseria meningitidis, which normally resides in the human nasopharynx but is also a leading cause of sepsis and epidemic meningitis. Using N. meningitidis as model organism, we tested the hypothesis that virulence of commensal pathogens is a consequence of within host evolution and selection of invasive variants due to mutations at contingency genes, a mechanism called phase variation...
2017: PloS One
https://www.readbyqxmd.com/read/28079790/ecthyma-gangrenosum-a-skin-manifestation-of-pseudomonas-aeruginosa-sepsis-in-a-previously-healthy-child-a-case-report
#16
Stephanie Biscaye, Diane Demonchy, Mickael Afanetti, Audrey Dupont, Herve Haas, Antoine Tran
RATIONALE: Ecthyma gangrenosum (Eg) is a necrotic lesion that is mostly seen in immunocompromised patients. It reflects a severe sepsis, possibly caused by Pseudomonas aeruginosa (Pa). PATIENT CONCERNS: A healthy 3-year-old girl admitted to the Pediatric Emergency Department presented a sepsis-associated purpura with neurological and respiratory distress. INTERVENTIONS: An empiric antibiotherapy (anti-meningococcal) was prescribed. DIAGNOSES: Forty-eight hours after admission, blood and wound cultures were positive for Pa...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28069783/secondary-asplenia-as-a-complication-of-severe-meningococcal-sepsis
#17
Lourdes Castillo-Campos, Luis Bachiller-Carnicero, María José Megía-Sevilla, María Isabel González-Tomé
We report the case of an 11-month-old infant who had a medical history of meningococcal septicaemia 6 months prior to this admission and presented to hospital with an episode of fever due to Streptococcus pneumoniae bacteraemia. During this second admission, an abdominal ultrasound scan revealed secondary asplenia.
January 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28024455/the-neisseria-meningitidis-lpxl1-mutant-induces-less-tissue-factor-expression-and-activity-in-primary-human-monocytes-and-monocyte-derived-microvesicles-than-the-wild-type-meningococcus
#18
Marit Hellum, Anne-Marie S Trøseid, Jens P Berg, Petter Brandtzaeg, Reidun Øvstebø, Carola E Henriksson
Neisseria meningitidis (N. meningitidis) may cause sepsis and meningitis. N. meningitidis with a mutated lpxL1 gene has five, instead of six, acyl chains in the lipid A moiety. Compared with patients infected with the wild type (wt) meningococcus, patients infected with the lpxL1 mutant have a mild meningococcal disease with less systemic inflammation and less coagulopathy. Circulating tissue factor (TF), the main initiator of coagulation, has a central role in the development of coagulation disturbances during sepsis...
February 2017: Innate Immunity
https://www.readbyqxmd.com/read/27994836/an-unexpected-fever-post-serogroup-b-meningococcal-sepsis
#19
Daniele Donà, Elisa Gnoato, Carlo Giaquinto, Carlo Moretti
This case report describes an invasive meningococcal group B infection followed by the development of Kawasaki disease (KD) complicated by macrophage activation syndrome (MAS) in a 2-year-old child. The presented case indicates the possible etiologic relationship between meningococcal sepsis and KD as support of bacterial toxin induced theory. It's important to maintain a high grade of suspicious for KD in every relapse of fever also during convalescence phase of severe infection. Usually, initial treatment with intravenous immunoglobulin is sufficient to control the disease; but, in case of refractory KD complicated by MAS, corticosteroid therapy represents a good option inducing prompt fever resolution and clinical improvement...
November 17, 2016: Pediatric Reports
https://www.readbyqxmd.com/read/27921012/expression-of-the-gene-for-autotransporter-autb-of-neisseria-meningitidis-affects-biofilm-formation-and-epithelial-transmigration
#20
Jesús Arenas, Fernanda L Paganelli, Patricia Rodríguez-Castaño, Sara Cano-Crespo, Arie van der Ende, Jos P M van Putten, Jan Tommassen
Neisseria meningitidis is a Gram-negative bacterium that resides as a commensal in the upper respiratory tract of humans, but occasionally, it invades the host and causes sepsis and/or meningitis. The bacterium can produce eight autotransporters, seven of which have been studied to some detail. The remaining one, AutB, has not been characterized yet. Here, we show that the autB gene is broadly distributed among pathogenic Neisseria spp. The gene is intact in most meningococcal strains. However, its expression is prone to phase variation due to slipped-strand mispairing at AAGC repeats located within the DNA encoding the signal sequence and is switched off in the vast majority of these strains...
2016: Frontiers in Cellular and Infection Microbiology
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