Stockdoc, Only 5% to 10% of meningococcal disease are meningococcemia
(septic shock type) 90% to 95% are meningitis.
Meningococcemia is a clinical syndrome: massive fulminant septic shock. A lot has to do with patient susceptibility, in about 50% of case there is not associated meningitis.
Menigitic meningococci disease: (meningitis by Neiseria meningitidis, same bacteria of the above)is an acute, but not necessarily fulminant syndrome. Most of the patients will have the bacteria in the blood . One could see it in the blood with a regular Gram stain technique, and a regular blood culture will detect about 70% of cases, pcr is helping to detect a lot more cases in the UK, also available in the US but not widely use (pcr is widely use for many other problems, including dna testing in the forensic pathology field). These patients will not have the fulminant inflammatory cascade activation, of course if left without treatment they will progress to the septic shock, this is not common except in countries with poor health care systems.
The group of patients with meningococcemia (septic shock) are the ones in the Bpi trial, there are about 3,000 cases a year in the US and this is the main reason the bpi trial takes so long. Meningitis cases are about 30,000 a year.
Peritoneal Ventilation (save me from both gasses, Amen). |
