I was recently involved in the care of a 17-year-old boy who had meningococcal meningitis. This is a rare bacterial infection, but meningococcal disease continues to cause 75 to 125 deaths per year in the U.S.
Meningococcal meningitis often begins with nonspecific symptoms like a viral-type illness. That means fever, body aches, vomiting and headache. But over a fairly short period of time these symptoms worsen and a stiff neck often develops.
The patient in our practice also became very lethargic, developed a skin rash and did not seem to respond to his parents when asked him questions. He became sicker fairly quickly, which was quite noticeable to his parents.
When the boy was seen in the ER, he was thought to have meningitis, and a spinal tap confirmed this. He was also having problems maintaining his blood pressure and appeared critically ill. The boy was admitted to the intensive care unit at the hospital and started on antibiotics, as well as extensive supportive care.
He did well and was a very lucky kid, as meningococcal infections can be fatal. Also, most patients with meningococcal disease have some aftereffects, including seizures, hearing loss, or other neurological damage.
The point of this story is to remind parents that their adolescent children need to be vaccinated against meningococcal disease, beginning at age 11, followed by a booster dose at age 16. The vaccine covers only certain types (A, C, W and Y) of this bacterial infection, called serotypes.
Currently, the most common serotypes causing disease in adolescents in the U.S. are C and Y, while other parts of the world have disease due other serotypes. In this young man’s case, his illness was due to serotype B disease, which, unfortunately, is not covered by a vaccine.
While you’re visiting your pediatrician for your teen’s annual checkup, make sure that your child gets the meningococcal vaccine. This case served as a great reminder. Fortunately, this was an isolated case as we watched for any other such illness in the community. The incubation period after exposure is two to 10 days.
Dr. Sue Hubbard is a pediatrician, medical editor and media host. Submit questions at kidsdr.com.