4.8 Article

Prevention of meningococcal disease

Journal

NEW ENGLAND JOURNAL OF MEDICINE
Volume 355, Issue 14, Pages 1466-1473

Publisher

MASSACHUSETTS MEDICAL SOC
DOI: 10.1056/NEJMcp063561

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A previously healthy 18-year-old college freshman presented to an emergency department with acute onset of fever and headache. He was listless and in distress. His temperature was 40.0 degrees C, his pulse was 140 per minute, his blood pressure was 70/40 mm Hg, and his respirations were 35 per minute. Petechiae were noted over his thorax. Meningococcal septicemia was suspected ( and subsequently confirmed by the growth of Neisseria meningitidis serogroup C isolated from blood). Despite the prompt administration of antibiotics and other support, the patient's illness was fulminant and he died 12 hours after the onset of the symptoms. Should he have previously received meningococcal vaccine, and what measures should be taken to protect his close contacts and his community?

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