Meningococcus

The UK outbreak is Meningococcus B specifically.

Right.

Neisseria meningitidis serogroup B.

And the numbers are stark.

MenB caused 97% of invasive meningococcal disease in 15 to 24-year-olds in England this past season.

It tells you where the inflammation is, not what's causing it or how dangerous it is.

The CDC explicitly warns that meningitis and meningococcal disease aren't the same thing.

Meningococcal disease is any illness caused by Neisseria meningitidis, which can include meningitis, but also bloodstream infection without meningitis.

So that's the vancomycin, cefuroxime.

And it so happens that cefuroxime also covers this other major player in, in, uh, uh, uh, in community-acquired meningitis, which is Neisseria meningitidis, which would be, uh, based on her age, a plausible diagnosis.

Uh, and then the ampicillin is used in select patient populations who are at risk of listeria.

Listeria doesn't affect everybody.

So whether it's history of surgical splenectomy, whether it's a situation like autosplenectomy and sickle cell, which clearly we don't have sickled RBCs here, but if you lose the spleen then you get Howell-Jolly bodies on a smear, okay? They really like that and in terms of what they can do on USMLE is give you a smear just like this and then ask you for the vaccine that the patient needs and they want Strep pneumo as number one.

Obviously you need a vaccine against Neisseria meningitidis as well and Haemophilus influenzae type B.

Okay, those are the three but Strep pneumo is the, the number one important, uh, organism infections that you can get if, uh, you don't have a spleen.

Okay, it's a lengthy seminar on this stuff but, uh, encapsulated organism infections.

So yes, it is all part of that.

But this is a very specific sort of meningitis caused by Neisseria meningitidis.

That's the bug that causes meningococcal disease.

And this specific form is quite hard to contract.