Infectious diseases. Meningococcal infection. Etiology. Epidemiology. Pathogenesis. Pathomorphology (most important)

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Infectious diseases. Meningococcal infection. Etiology. Epidemiology. Pathogenesis. Pathomorphology (most important)

Lecture notes, cheat sheets

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9. Meningococcal infection. Etiology. Epidemiology. Pathogenesis. Pathomorphology

Meningococcal disease is an acute human infectious disease caused by meningococcus. It is characterized by a variety of clinical forms - from nasopharyngitis and healthy carriage to generalized, occurring in the form of meningococcemia, meningitis and meningoencephalitis.

Etiology. The causative agent of meningococcal infection, Neisseria meningitidis, is a gram-positive diplococcus that is located intra- and extracellularly. Whimsical to the conditions of cultivation, sensitive to various environmental factors. Meningococcal disease only affects humans.

The disease develops when these microorganisms enter the bloodstream and spread throughout all organs.

Epidemiology. Meningococcal meningitis is a disease of childhood, more than half of the cases occur in children of the first 3 years of life. Infection occurs from adult bacteria carriers, less often through contact with patients or bacteria carriers in medical institutions or kindergartens.

Pathogenesis. In the pathogenesis of the disease, the pathogen, its endotoxin and allergenic substance play a leading role. The entrance gates of infection are the mucous membranes of the nasopharynx and oropharynx. In some individuals, meningococci penetrate the mucous membrane, are captured by leukocytes, and are carried through the bloodstream throughout the body, entering the eyes, ears, lungs, joints, meninges, heart, and adrenal glands. Specific group antibodies to meningococci are formed after a long bacteriocarrier.

Carriage in the nasopharynx of non-typable meningococci belonging to serotypes X, Y and Z or producing lactose is accompanied by the production of antibodies to meningococci serotypes A, B and C. Bactericidal antibodies that cross-react with meningococci can also be formed when infected with other gram-negative and gram-positive bacteria and many people prevent the development of meningococcemia.

Pathomorphology. The disease caused by meningococci is accompanied by an acute inflammatory reaction. Endotoxemia can lead to diffuse vasculitis and disseminated intravascular coagulation. Vessels of small caliber are filled with clots containing a large amount of fibrin and leukocytes. Hemorrhages and necrosis are found in all organs, hemorrhages in the adrenal glands are especially characteristic of patients with clinical signs of septicemia and shock.

Meningococcal infection is more common in individuals with a deficiency of the terminal component of complement (C5-C9), as well as in the depletion of the complement system. Fulminant meningococcal infection develops in family members with congenital disorders of the alternative pathway of complement conversion, properdin. Predisposition to meningococcal infections is associated with the presence of leukocyte histoantigen B27, which is statistically confirmed. There is also dependence on immunoglobulin G2 deficiency.

Author: Pavlova N.V.

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