Patient selection: evidence of meningococcal infection (definitive culture and identification, presumptive)
Criteria for meningococcal sepsis:
(1) petechia and/or purpura fulminans
(2) tachycardia
(3) tachypnea
(4) body temperature < 36°C or > 38.5°C
If age <= 18 years then pediatric.
If age > 18 years then adult.
Criteria for meningococcal septic shock:
(1) presence of meningococcal sepsis
(2) one or both of the following:
(2a) persistent hypotension despite adequate volume resuscitation
(2b) 2 or more features of poor end-organ perfusion
Features of poor end-organ perfusion:
(1) pH <= 7.3
(2) base deficit < -5
(3) plasma lactate > 2.0 mmol/L
(4) arterial hypoxia (PaO2 < 75 mm Hg, PaO2/FIO2 ratio < 250 or transcutaneous oxygen saturation < 96%) without pre-existing pulmonary disease
(5) acute renal failure (urine output < 0.5 mL per kg per hour for at least 1 hour despite adequate fluid volume loading and without pre-existing renal disease)
(6) sudden deterioration of baseline mental status not resulting from meningitis
