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As 42-year-old Majeed Muhammad struggled with a severe bloodstream infection for 20 long days, he thought he wouldn't make it. He was diagnosed with acute meningococcemia, a deadly disease that has been around since the 1800s.
Muhammad remembered going to Lifecare Hospital, Musaffah, feeling weak and in pain — made worse by a high fever that didn't subside with over-the-counter medicines.
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“I never had such fever. I was suffering from muscle pain, dizziness, and severe pain in my feet," the Abu Dhabi resident said. "When I developed breathing problems, I thought I may not recover at all."
Doctors who saw him at the emergency room were both alarmed and confused as they observed his symptoms.
“The patient was quite sick. He came to the emergency room with a fever and significant hypotension (low blood pressure) — indicating shock," said Dr Baiju Faizal, internal medicine consultant at Lifecare Hospital, Musaffah.
"However, preliminary investigations did not reveal common reasons for shock. We suspected sepsis (a condition where the body does not respond to an infection). The mild purple skin colour change on his feet aroused the suspicion of meningococcal infection,” Dr Faizal said.
His condition gradually worsened and started affecting multiple organs.
Things took a drastic turn when he suddenly developed various conditions, including acute kidney failure, acute respiratory distress syndrome, abnormal blood clotting in blood vessels, and gangrene of the toes.
Meningococcal disease was first discovered in 1805, dreaded because of its epidemic nature. In the last decade of the 19th century, the concept of serum therapy for toxin-related bacterial diseases was identified.
This concept was applied to meningococcal disease therapy in an independent way, resulting in the first successful approach for the treatment of the disease. During the first three decades of the 20th century, serum therapy was the standard treatment for meningococcal disease.
To rule out doubts, the medical team ran all necessary tests, which showed evidence of renal failure, high blood lactate, and elevated blood counts.
Later, Dr Seema Oommen, consultant microbiologist at Burjeel Medical City, confirmed their suspicions about the presence of Neisseria meningitidis, a bacterium that causes meningococcemia.
Acute meningococcemia is a highly complicated infection that affects multiple organs like the blood vessels, brain, kidneys, and adrenal glands, doctors said. This disease, declared as endemic in certain regions, has been controlled through vaccinations across the globe.
“Muhammad showed Disseminated Intravascular Coagulation (DIC), a severe outcome of meningococcemia, which produced both clots and bleeding. The small clots called microthrombi brought damage to his feet,” said Dr Faizal.
Dr Faizal was aided by Dr Abeesh Pillai, consultant nephrologist; Dr Ashraf Talat, critical care head; Dr Priyanka Gupta, critical care physician; Dr Mathew Vadukoot L, specialist gastroenterology; Dr Muhammed Noufal, specialist pulmonologist; and the surgical team comprising Dr Bibek Chakrabarthy, specialist general surgery; Dr Mittu John, specialist general surgery; and Dr Prathap Potula, consultant vascular surgery.
Despite the highly complicated situation, Muhammad made a recovery under the guidance of the expert team.
“About 1 in 10 people carry these bacteria at the back of their nose and throat without being ill. Sometimes, the bacteria invade the body, causing meningococcal disease. Generally, it takes close contact, such as coughing, kissing, sharing a room, or lengthy contact to spread these bacteria. Muhammad likely got it from one of his close contacts,” said Dr Faizal.
The team treated the patient with broad-spectrum antibiotics. Kidney failure was managed through haemodialysis, while respiratory distress was treated by mechanical ventilation for a few days. For severe DIC, he was given Fresh Frozen Plasma (FFP) and blood thinner for microthrombi and gangrene of the toes. Besides, the infection control team immediately traced his close contacts and administered prophylactic antibiotics to prevent the infection from spreading.
Thanks to the timely diagnosis and care, Muhammad made a full recovery and was able to walk out of the hospital healthy.
“Fortunately, I was cared for by the team of doctors, nursing staff, and physiotherapists. Even during tough times, they kept me positive. Surviving an infection that affected many organs is a blessing from the Almighty. I am now able to walk. Some black colour remains on my toes, but there’s no pain. I am grateful to everyone who helped me,” said Muhammad.
Having realised the importance of following healthy habits and seeking professional help as soon as possible, Muhammad is determined to do follow-ups with the doctor to care for his toes and get vaccinated to prevent future occurrences.
Meningococcemia is not as contagious as the common cold or the flu. However, those who share the same household/rooms or have direct contact with the patient’s oral secretions are at high risk. In addition, patients with non-functioning spleen, complement deficiencies have a high risk of recurrent meningococcemia.
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