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Meningococcal infections 

Meningococcal infections
Chapter:
Meningococcal infections
Author(s):

Petter Brandtzaeg

DOI:
10.1093/med/9780198746690.003.0109
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date: 05 March 2021

Neisseria meningitidis is an obligate human Gram-negative diplococcus. It is carried in the nasopharynx by about 3–10% of people, with most strains being harmless and inducing immunity. Pathogenic strains usually belong to specific clones that are encapsulated, express pili, and the major porin, PorA. Serogroups A, B, and C usually account for more than 90% of all invasive isolates. Meningitis is the commonest presentation; preceded by low-grade meningococcaemia. After transition to the subarachnoid space the meningococci proliferate to high levels in the cerebrospinal fluid. Clinically the patients develop fever, subsequently a petechial rash and increasing symptoms of meningitis. If adequately treated with antibiotics, case fatality is less than 1–2% in industrialized countries, but higher in developing countries. Brain oedema leading to herniation of the cerebellum is the main cause of death. Neurosensory hearing loss is the major complication.

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