Meningococcemia: rare but life-threatening

Blood workout revealed leucopenia (2.600/mm3) with neutropenia (2.00/mm3), C reactive protein 89 mg/L, urea nitrogen 30 mg/dL, creatinine 0.8 mg/dL and a metabolic acidosis (pH 7.176, pCO229.3 mm Hg, HCO3 10.6 mmol/L, lactates 5 mmol/L). N. meningitidis is a Gram-negative bacteria that can be highly pathogenic in humans, the only host. Since 2008, the European incidence rate of meningococcal disease is 0.68/100 000, with the highest cases among children younger than 5 years.1 Concerning invasive disease, serogroup B is the most common, followed by serogroup C. In these cases, early antibiotics, aggressive initial shock approach and precocious referral to intensive care are potential factors with impact on reducing its mortality.2 3 The Portuguese immunisation programme only covers the serogroup C but vaccine for serogroup B (MenB), although expensive, is available for purchase. Nowadays serogroup B is the main meningococcal disease-causing agent, so immunisation with the MenB conjugate vaccine should be recommended and included in national infant immunisation programmes.