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Meningococcal infection

Meningococcal infection is an acute infectious disease caused by Neisseria meningitidis meningococcus, characterized by various clinical severity and nature: from mild nasopharyngitis and carriage to generalized forms - purulent meningitis and meningococcemia.

Clinical diagnosis

The incubation period is from 1 to 10 days (usually 5-7 days).

Acute nasopharyngitis. Fever, moderate intoxication, rhinopharyngitis.

Meningitis. The onset is acute or sudden. Occasionally, a prodrome in the form of nasopharyngitis. Fever, agitation, headache, vomiting, general hyperesthesia, meningeal symptoms, swelling and tension of the large fontanel.

Pose: on the side, with bent legs and a thrown back head. Delirium, agitation, impaired consciousness, convulsions, tremors. Tendon reflexes are enlivened, then reduced.

Meningoencephalitis. Pathological reflexes, paresis, paralysis.

Meningococcemia. Acute onset, temperature, pallor. Rashes on the skin of the abdomen, buttocks, thighs from small hemorrhagic "star" elements to large hemorrhagic elements with necrosis in the center on all skin integuments.

The clinical picture of infectious toxic shock, Waters-Friederichsen syndrome: a decrease in temperature to normal numbers, a drop in blood pressure, a filiform pulse, shortness of breath, acrocyanosis, general cyanosis, oligoanuria, impaired consciousness, coma, vomiting of "coffee grounds", DIC.

Laboratory diagnostics

1. The microscopic method. From the first days of the disease, in smears from a sediment of cerebrospinal fluid, from hemorrhagic rashes, and less often from blood, gram (-), bean-like, intracellular diplococci are found.

2. The bacteriological method. From the first days of the disease, cerebrospinal fluid, blood, nasopharyngeal mucus, material from hemorrhagic rash elements are sown on serum or ascites agar with ristomycin in order to isolate meningococci.

3. The serological method. Paired sera are examined in RPHA to detect antibodies and increase their titer on days 5-7 of the disease and in dynamics.

4. The method of immunodiagnostics. Detection in meninococcal hypertension in the blood or cerebrospinal fluid in the reaction of oncoming immunoelectroosmophoresis (VIEF).

5. Other methods. When examining the cerebrospinal fluid, an increase in pressure is detected (norm 130-180 mm of water.
Art. , or 40-60 drops per minute), determine cytosis (number of cells in 1 mm, normal - up to 8-10), cytogram (normal: lymphocytes 80-85%), protein (normal 0.22-0.33 g / l), sugar content (norm 0.2-0.3 g / l or 2.8-3.9 mmol / l) and chlorides (norm 120-130 mmol / l, or 7-7.5 g / l) . With meningitis: pressure increased, neutrophilic cytosis up to 10,000 in 1 mm, an increase in protein, a decrease in sugar and chlorides. In the study of peripheral blood, hyperleukocytosis with a sharp shift to the left is detected.

Activities for patients and contacts

Hospitalization. Mandatory for patients with a generalized form.

Hospitalization of patients with nasopharyngitis is carried out according to clinical and epidemiological indications. Carriers of meningococcus are not subject to hospitalization.

Isolation contact. It is produced until a single negative result is obtained from the study of mucus from the nasopharynx. Contact with the carrier of meningococcus is not isolated. In teams - foci of infection, medical observation is established for 10 days.

Statement conditions. After clinical recovery and a negative result of a single bacteriological examination of mucus from the nasopharynx, carried out no earlier than 3 days after the end of etiotropic therapy.

Admission to the team. Reconvalescents are allowed in the children's team after receiving a negative result of a single bacteriological examination of mucus from the nasopharynx, carried out no earlier than 5 days after discharge from the hospital.

Carriers of meningococcus are allowed into the team after treatment and a negative result of bacteriological examination of mucus from the nasopharynx, carried out no earlier than 3 days after the end of rehabilitation.

Clinical examination: Those who underwent meningitis without residual effects are observed for 2 years with a neuropsychiatrist examination 4 times in the 1st year of observation and 1-2 times in the 2nd year. In the presence of residual effects - active treatment and observation for at least 3-5 years

Specific prophylaxis

Chemical polysaccharide meningococcal vaccine is vaccinated for prophylactic purposes and in foci of infection for emergency prevention for children over 5 years old and adults.

Nonspecific Prevention

General measures are the same as with other airborne infections. Children under 5 years of age, in contact with the generalized form, can use immunoglobulin.
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Meningococcal infection

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