Bacterial meningitis is a dreaded disease that’s caused when bacteria called Neisseria meningitidis infects the protective covering of the brain and spinal cord, called meninges. The bacteria are often spread through food. Fast diagnosis and treatment are keys to survival. Texans may remember a meningitis outbreak related to a popular ice cream brand several years ago.
A lesser-known cousin of bacterial meningitis is meningococcemia. It’s caused by the same bacteria but doesn’t spread to the brain and spinal cord meninges, but instead colonizes and thrives in the bloodstream.
Who’s at risk for meningococcemia?
As with many medical conditions, anyone can develop the severe blood infection meningococcemia. It’s more common, though, in infants and young children, who account for about one-half of all cases.
When it comes to adults, epidemiological data show an increased risk for freshman living in dormitories, service members living in barracks, and others living in similarly crowded group living situations. It’s common for doctors to recommend meningococcemia vaccination for patients getting ready to move into those settings.
Signs and symptoms
According to a pediatric critical care medical expert, the classic sign of meningococcemia that doctors are on the look for is purpura, which are dark purple-colored spots on the skin. Another classic sign for this condition or meningitis in general is a stiff neck.
Other signs and symptoms are more generalized, including things such as:
• Fever
• Nausea
• Vomiting
• Headache
• Red rash
For infants, parents may notice that the baby is unusually inconsolable. A fussy baby combined with a rash or purpura should certainly warrant a trip to the emergency room an immediate evaluation by a physician.
Because meningococcemia can progress rapidly, time is of the essence for identifying the problem in getting treatment. When parents seek medical attention, but a doctor, nurse practitioner, or physician’s assistant downplays the symptoms rather than fully investigating and treating them, it creates a needlessly dangerous situation.
That’s exactly what happened to an infant in a Houston, Texas suburb one holiday weekend.
Parents noticed that their baby had a fever of over 103 degrees, with wheezing and difficulty breathing, poor appetite, and just generally behaving abnormally. The parents were on top of things and took the infant to an urgent care clinic, where a doctor saw the patient and documented in the medical record that she had a skin rash, papules (raised areas on the skin without visible fluid beneath them), chest congestion, cough.
The doctor ordered a flu test, which came back negative, and then sent her home with diagnoses of fever, a respiratory infection, and a rash.
About six hours later, the parents were concerned that their child wasn’t getting any better. With the holiday approaching, they decided to take her to a suburban hospital. They explained to the emergency physician that their baby had the sniffles (nasal congestion), a rash, poor appetite, and wasn’t wetting her diapers much as normal. The doctor ordered another flu test and a urine sample to rule out a urinary tract infection. They gave her acetaminophen to reduce her fever, some intravenous (IV) fluids to give her a boost because of suspected dehydration and discharged her with prescriptions for an anti-nausea medication.
The next morning, the parents rushed her back to the same hospital emergency room after finding the baby almost unresponsive, and rash that looked like bruising all over her body. This time, a doctor quickly admitted her to the hospital and found that she was in septic shock and multiple vital organs were failing. Sepsis is a system-wide hyper inflammatory response to an infection that can be deadly if it’s not diagnosed and treated immediately.
The medical team on the second hospital visit also diagnosed this little one with purpura fulminans because of meningococcemia. She spent three months in the hospital and almost didn’t survive.
Treatment
The frightening part of this stories was that parents did everything right. They knew their child and acted immediately when they saw that something wasn’t right. The healthcare providers really dropped the ball and let this family down.
According to medical experts, the standard of care in a situation of suspected meningococcemia infection, is that the doctor should start with ordering stat/immediate aggressive IV antibiotics. The next orders would include an extensive workup to verify the infection. This could be done by laboratory analysis of bloodwork or cerebrospinal fluid (CSF) collected by a lumbar/spinal tap.
When the infection thrusts a patient to sepsis, the standard of care further requires aggressive IV fluid resuscitation. A team of providers also has to look for and treat other common complications of a meningococcemia infection, including a plummeting low blood pressure (treated with medications) and difficulty breathing (addressed with supplemental oxygen). That's because this serious infection can also cause depletion of platelets, a condition called thrombocytopenia, doctors may also have to order platelets replacement therapy.
The failure to implement timely treatment of meningococcemia can be devastating, causing extensive skin damage all over the body, gangrene, and even death.
If you or a love one has been seriously injured because of poor care related to a meningococcemia infection, then contact a top-rated skilled Houston, Texas medical malpractice lawyer for help in evaluating your potential case.
