Meningokokal

Meningokokal refers to Neisseria meningitidis, a bacterium that can colonize the nasopharynx and cause serious illness such as meningitis or meningococcemia. It is transmitted from person to person through respiratory droplets and close contact. Carriage in healthy individuals is relatively common, but meningococcal disease is uncommon and can progress rapidly.

Clinical presentation varies. Meningitis typically presents with fever, severe headache, neck stiffness, photophobia, and altered consciousness. Meningococcemia can occur with fever, malaise, a rapidly developing purpuric or petechial rash, and potential shock due to disseminated intravascular coagulation. In children and adolescents, symptoms may be nonspecific in early stages, necessitating prompt medical evaluation.

Diagnosis relies on timely laboratory testing. Suspected meningococcal disease is investigated with lumbar puncture to examine cerebrospinal fluid, looking for neutrophilic pleocytosis, low glucose, and high protein, with Gram stain showing Gram-negative diplococci. Confirmatory tests include culture of CSF or blood and molecular methods such as PCR.

Treatment requires urgent antibiotic therapy. Empiric therapy typically involves a third-generation cephalosporin, such as ceftriaxone or cefotaxime, with adjustments made after organism identification and susceptibility results. Supportive care, monitoring, and management of complications in an intensive setting may be necessary.

Prevention is a key component of meningokokal control. Vaccination against meningococcal disease includes vaccines targeting serogroups A, C, W, and Y (MenACWY) and vaccines for serogroup B (MenB), with schedules varying by country. Post-exposure prophylaxis for close contacts, using rifampin, ciprofloxacin, or ceftriaxone, is recommended in many guidelines. Public health surveillance and outbreak control are important in managing regional risks.