Neisseria Meningitidis


  • Gram (-), kidney or coffee-bean shaped intracellular diplococci
  • Ferments glucose and maltose with acid production but not sucrose or lactose
  • Inhabits the nasopharynx of sick persons and carriers
  • Portal of entry: nasopharynx; invades bloodstream and enters the meninges of the brain
  • Mode of transmission: direct personal contact through droplet infection from a sick person or carrier
  • Causes meningococci meningitis or spotted fever

Antigenic Substance

  • P substance – a protein substance common to all types of meningococci; highly toxic to rabbits
  • C substance – a polysaccharide found in all types of meningococci
  • Type-specific antigen – a polysaccharide polypeptide complex found in types 1 and 3

Meningococci Meningitis or Spotted Fever

  • It is an acute, communicable bacterial disease affecting the meninges.
  • It is always serious.

Signs and Symptoms

From the bloodstream, the infecting organisms may cross the blood-brain barrier and infect the meninges, causeing the major symptoms of:

  • Severe headache
  • Irritability
  • Vomiting
  • Chills with high grade fever
  • Rapid pulse
  • Convulsions (especially in infants)
  • Rigidity of the muscles especially those of the neck and back
  • Orthotonus (head becomes fixed, body and limb in rigid straight line)
  • Pain on flexing the neck
  • Kernig’s sign (knees become fixed and cannot be extended)
  • Brudzinski’s sign (elevation of the head, thorax and legs)
  • Confusion
  • Delirium progressing to stupor (unconscious stage)
  • Coma


  • Penicillin G as the drug of choice. It inhibits cell wall synthesis.
  • Sulfonamides especially sulfadiazine and sulfamerazine are alternative drugs of choice since they can readily cross the blood-brain barrier. Acts as bacteriostatic and atntimetabolites of PABA (para-amino-benzoic acid).
  • Cephalosporin like cefotaxime, chloramphenicol or chloromycetin and erythromycin are third generation drugs effective in persons allergic to penicillin. They inhibit also cell wall synthesis.
  • Rifampicin 600 mg can eradicate the carrier state and can be used for chmoprophylaxis for household and other close contact.

Prevention and Control

  • Isolation of sick persons
  • Treatment of carriers
  • Awareness against sneezing of infected individuals
  • Skin care
  • Oral and nasal hygiene
  • Maintenance of clean surrounding
  • Reduction of personal contacts in a population with a high carrier rate. This can be done by avoidance of crowding.

Photo credits:

Daisy Jane Antipuesto RN MN

Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.

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