Meningitis & Teens

I was recently involved in the care of a 17 year-old boy in our practice who had meningococcal meningitis.  Meningococcal meningitis is a rare bacterial infection, but meningococcal disease continues to cause 75-125 deaths/year in the U.S.  Meningococcal meningitis often begins with non-specific 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 will often occur. 

The patient in our practice also became very lethargic, developed a skin rash and did not seem to respond to his parents when they were asking him questions. He definitely became sicker fairly quickly and it was quite noticeable to his parents. 

When he was seen in the ER he was immediately thought to have meningitis and had a spinal tap which confirmed this. He was also having problems with maintaining his blood pressure and appeared critically ill.  He was admitted to the ICU and started on antibiotics as well as extensive supportive care. 

The best news is that he is doing well!  He is a very lucky kid as there are often deaths reported due to meningococcal infections. Most patients who have meningococcal disease have some after effects including seizures, hearing loss or other neurological damage.  It is a BAD disease.

The point of this story is to remind parents that their adolescent children need to be vaccinated against meningococcal disease, beginning at age 11 and with a booster dose at age 16 years.  The vaccine only covers certain different types of this bacterial infection, and these are called serotypes. The vaccine covers serotypes A, C, W and Y. 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 mans case, his illness was due to serotype B disease which  unfortunately is not covered by a vaccine. 

So, while you are seeing your pediatrician for check ups this summer, make sure that they received the meningococcal vaccine.  This case served as a great reminder.  Fortunately, his was an isolated case as we watched for any other illness in our community.  The incubation period after exposure is 2-10 days.

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