Meningococcal septicaemia

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Meningococcal septicaemia (meningococcaemia, meningococcemia) is a form of meningococcal disease associated with hyperinvasive serotypes of Neisseria meningitidis and associated even with appropriate antibiotic treatment with mortality rates of about 20%. The serotypes are A, B, C, Y and W-135 and are associated with dysfunction of endothelial protein C activation[1]. Death due to fulminant meningococcal septicaemia may occur within hours of the first symptoms. While characteristic rashes (purpura fulminans) due to occlusion of small vessels by antigen antibody interaction in the dermis of skin are found in more than 80% cases it may be absent during early phase of illness or in overwhelming sepsis. The pathophysiology involves direct bacterial toxicity through say lipopolysaccharide endotoxin components of the meningococcal cell wall, cytokine release, ischaemia, vasculitis and oedema[2].