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Meningococcemia is a topic covered in the 5-Minute Emergency Consult.

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  • Bacterial illness caused by Neisseria meningitidis
  • Several forms of illness may occur
  • Mild meningococcemia
  • Overwhelming meningococcal sepsis
  • Meningococcal meningitis
  • Chronic/occult meningococcemia
  • Septic arthritis
  • Acquired from close contact with an infected individual or an asymptomatic carrier
  • Intimate kissing and cigarette smoking are independent risk factors.


  • N. meningitidis:
    • Serotypes A, B, C, D, H, I, K, L, X, Y, Z, 29E, and W135
    • Serotype B is most common in US
    • Majority of infections caused by A, B, C, X, Y, and W135
  • Bacteria attach to and enter nasopharyngeal epithelial cells.
  • Bacteria spread from the nasopharynx through the bloodstream via entry of vascular endothelium.
  • Most circulating meningococci are eliminated by the spleen.
  • Meningococci produce an endotoxin (lipooligosaccharide):
    • Involved in pathogenesis of the skin, adrenal manifestations, and vascular collapse
  • Human oropharynx/nasopharynx is the only reservoir.
  • Carrier usually has developed immunity to serotype-specific antibody (not immune to all serotypes):
    • Age <5 yr: 1% carrier rate
    • Age 20–40 yr: 30–40% carrier rate
    • Lower rate of immunity in children, which is reflected by the higher rates of infection
  • Most common in fall and spring
  • Increased incidence in military recruits and close living conditions
  • Epidemics—ages 5–9 yr most/earliest affected

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Rosen, Peter, et al., editors. "Meningococcemia." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307025/all/Meningococcemia.
Meningococcemia. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307025/all/Meningococcemia. Accessed April 25, 2019.
Meningococcemia. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307025/all/Meningococcemia
Meningococcemia [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 25]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307025/all/Meningococcemia.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Meningococcemia ID - 307025 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307025/all/Meningococcemia PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -