After suffering a harrowing 20-day struggle between life and death, 42-year-old Majeed Muhammad is now living the second innings of his life. Diagnosed with acute meningococcemia, a severe bloodstream infection, he battled for his life in a hospital bed.
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.
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Muhammad arrived at Lifecare Hospital, Musaffah with symptoms such as high fever, dizziness, hypotension (low blood pressure), and rapid breathing. His condition gradually worsened, 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.
Life-threatening situation
Looking back, the expat felt scared. “I never had such fever. I was suffering from muscle pain, dizziness, and severe pain in my feet. As I developed breathing problems, I thought I may not recover at all,” said Muhammad, a resident of Abu Dhabi. Although he tried over-the-counter medicines before the hospital visit, the fever did not subside, leaving him more fatigued and in pain.
Dr Baiju Faizal, consultant of internal medicine at Lifecare Hospital, Musaffah, said that Muhammad’s condition was an uncommon situation. “The patient was quite sick. He came to the emergency room with a fever and significant hypotension, indicating shock. 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.
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.
According to doctors, a bloodstream infection caused by Neisseria meningitidis, acute meningococcemia is a highly complicated infection that affects multiple organs like the blood vessels, brain, kidneys, and adrenal glands. 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.
Path to recovery
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 hemodialysis, 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 realized 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.
How to avoid meningococcemia
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.
- Those in close contact of the patient should receive antibiotics to avoid getting infected
- People staying in crowded areas, going for pilgrimage, or microbiologists working with bacterium should take meningococcal vaccination
- High-risk individuals can take booster doses after five years