流脑知识讲稿.pptVIP

⒉ Fulminate form The patients with fulminate meningococcemia come on with an abrupt onset and extraordinarily rapid progression, occasionally less than 24 hours from onset to fatal termination. There is high mortality and most cases occur in child. fulminate meningococcemia ⑴ Shock form (Waterhouse-Friderichsen’s syndrome) A. Symptoms There are severe toxemic symptoms, such as abrupt onset, violent chills, high fever or hypothermia, restless or lethargy, and mental obtundation in the patients. hypothermia mental obtundation B. Rash Petechia appears initially on the extremities, they rapidly increase in number and coalesce, and may develop into purpura or necrosis. C. The features of fulminate meningococcemia Extensive purpura, acral cyanosis, hemorrhagic bullae, and peripheral gangrene are features of fulminate meningococcemia, usually occurring in the presence of shock and DIC. Petechia bullae gangrene in conjunctiva buccal mucosa D. Meningeal irritation usually is absent in most patients with fulminate meningococcemia . E. Cultures in blood and CSF Meningococcus is often positive blood culture. CSF is usually clear, containing normal level of leukocytes or few leukocytes. ⑵ Meningoencephalitic form Manifestations in encephalitis include mental obtundation, coma, recurrent seizures, positive in pathological reflexes such as Babinski sign. B. Manifestations in encephaledema Severe encephaledema can result in herniation, respiratory failure and death. coma seizure Babinski sign herniation ⑶ Mixed form (Meningococcemia-meningitis) Meningococcemia-meningitis has a poor prognosis and higher mortality. ⒊ Mild form (Mild acute meningococcemia) often occurred in late period of epidemic. ⑴ Clinical manifestations are t