Meningococcemia

What is meningococcemia?

Meningococcemia is a rare, life-threatening illness where bacteria gets into your bloodstream. It makes you very sick, very fast. It’s also called meningococcal septicemia.

The bacteria Neisseria meningitidis (N. meningitidis) causes meningococcemia. When it gets into your bloodstream, it destroys your blood vessels. This keeps blood from getting to your organs and tissues, which causes symptoms like cold hands and feet, severe muscle pain and pale or discolored skin. Blood leaking from broken blood vessels causes rash-like spots under your skin that start small but eventually get larger and more widespread.

Meningococcemia is a medical emergency that can quickly be fatal. Go to an emergency room immediately if you have symptoms of meningococcemia.

What’s the difference between meningitis and meningococcemia?

Meningococcemia and meningococcal meningitis are both types of meningococcal disease — illnesses caused by N. meningitidis. Meningococcal meningitis happens when the bacteria infect your brain and meningococcemia happens when the bacteria are in your blood. You can have both at the same time. Viruses, fungi or other bacteria can cause other types of meningitis if they infect your brain.

How common is meningococcemia?

Meningococcemia is rare. There are fewer than 400 cases of meningococcal disease in the U.S. every year.

What are the symptoms of meningococcemia?

Symptoms of meningococcemia are severe and get worse quickly (within hours). Many people describe it as feeling the worst they’ve ever felt. Symptoms include:

• Cold hands and feet.
• Severe muscle pain, often in your legs.
• Lethargy (extreme lack of energy).
• Rapid breathing.
• Abdominal (belly) pain.
• These can be violent, causing you to shiver or shake (rigors).
• Skin changes, like paleness or discolored patches.
• Flat, discolored (usually red, brown, blue or purple) areas that look like a rash. This will start small, usually in places where there’s pressure on your skin (petechiae). Look around your body, paying special attention to your armpits, waist or belt line, ankles, elbows and the inside of your thighs near your groin. It’ll eventually spread to cover large areas of your body (purpura). Don’t wait for the rash to spread to seek medical attention.

What causes meningococcemia?

The bacteria Neisseria meningitidis (also called meningococcus) causes meningococcemia. When you breathe it in, it can travel through your lungs to your bloodstream (meningococcemia) or your brain (meningitis). In your bloodstream, the bacteria destroy your blood vessels, which keeps your tissues from getting the oxygen they need.

How do you get meningococcemia?

N. meningitidis bacteria spread through close contact. This usually means kissing or sharing food, drinks or eating utensils. It can also sometimes spread to people you’re around a lot or live with, like roommates or family members.

What are the risk factors for meningococcemia?

The risk for meningococcemia is higher in:

• Infants.
• Teens.
• College students or young adults who live in group settings.
• People who travel to or live in certain parts of sub-Saharan Africa.
• People with certain immune disorders, including HIV and complement component deficiencies.
• People who take complement inhibitor medications for medical conditions.
• People without a spleen or whose spleens don’t function properly.

What are the complications of meningococcemia?

Complications of meningococcemia are life-threatening and can lead to permanent damage. They include:

• Septic shock, a condition that causes dangerously low blood pressure.
• Disseminated intravascular coagulation (DIC), a blood clotting disorder that can cause uncontrollable bleeding.
• Purpura fulminans, a form of DIC that causes your skin to die.
• Tissue death due to lack of blood flow (gangrene), which could require limb amputation.
• Inflammation of your heart muscle (myocarditis).
• Organ damage or failure.

How is meningococcemia diagnosed?

Providers test your blood or cerebrospinal fluid (fluid surrounding your brain and spine) to diagnose meningococcemia. But they’ll begin treating you with antibiotics right away — even before test results come back — if they think you could have meningococcemia.

What tests will be done to diagnose meningococcemia?

A provider might use one of these tests to look for the bacteria that cause meningococcemia:

• Lumbar puncture.
• Blood culture.

How is meningococcemia treated?

Providers treat meningococcemia with antibiotics, most commonly ceftriaxone, cefotaxime or penicillin. They may also:

• Perform surgery to remove dead tissue.
• Give you fluids or medication to increase your blood pressure.
• Give you oxygen through a mask or with a ventilator.

Can you prevent meningococcemia?

Getting meningococcal vaccines is the best way to prevent meningococcemia. There are two types of meningococcal vaccines, meningococcal conjugate/MenACWY and MenB. The Centers for Disease Control and Prevention (CDC) currently recommends:

• MenACWY for all 11- and 12-year-old kids with a booster shot at 16 years old.
• MenACWY for younger kids and adults at a higher risk for serogroup A, C, W or Y meningococcal disease.
• MenB for people at a higher risk for serogroup B meningococcal disease.

Healthcare providers also recommend that people who’ve been in close contact with someone with meningococcemia (kissing partners or people who live in the same home) should ask their provider about taking antibiotics. This might reduce their risk of meningococcal disease.

What can I expect if I have meningococcemia?

Providers will treat you in the hospital for several days. They’ll give you antibiotics directly into a vein through an IV. They may give you other treatments to manage any complications and to keep you comfortable.

Can meningococcemia be cured?

Yes, antibiotics can cure meningococcemia. But even after treatment, meningococcemia can leave long-lasting health effects. Talk to your provider about what to expect while recovering from meningococcemia.

Outlook for meningococcemia

Meningococcemia is fatal if left untreated. The mortality (death) rate of people treated with antibiotics is 10% to 15%.

When should I go to the ER?

Go to the emergency room immediately if you or your child has symptoms of meningococcemia. It gets worse quickly and can be deadly within hours.

What questions should I ask my doctor?

It might be helpful to ask your healthcare provider:

• What are my treatment options?
• How long will it take to feel better?
• How do I manage long-term effects or complications?
• Should my friends/family/roommates get preventive antibiotics?
• When should I follow up with you?

A note from Cleveland Clinic

Meningococcemia is very rare. Vaccines are available to help prevent it. But it’s still possible to get infected, so it’s important to get help right away if you have symptoms. Listen to your body — it can tell you when there’s something seriously wrong. If you or your child has any of the symptoms of meningococcemia, don’t wait for them to get worse. Go to the emergency room and tell your providers how you feel and your concerns. Getting treatment even a few hours earlier can make a difference in your recovery.