Step I Rash - meningococcaemia

[Phloston]

Can someone please explain the pathophysiology of the rash seen in meningococcaemia? Please be as specific as possible.

 

[thehundredthone]

Just red kinda things seen, you know, over the body. Infectious vasculitis. Gonna have to do the rest of the work yourself.

 

[ijn]

The rash in meningococcemia is due to DIC. It's not a vasculitis such as with RMSF.

 

[thehundredthone]

It might be both. Cutaneous vasculitis is a feature of meningococcemia. Although you're right, the intial purpuric rash is DIC related, and the infectious vasculitis is a later feature, so I'm probably wrong to say infectious vasculitis first.

http://www.histopathology-india.net/Menin.htm
"The cutaneous lesions in meningococcal septicemia show an acute vasculitis with fibrin thrombi in the small blood vessels of the dermis and extravasation of fibrin . There are neutrophils in and around the vessels. Leukocytoclasis is not a conspicuous feature.
In pustular lesions of chronic meningococcemia there are intraepidermal & subepidermal collections of neutrophils. Vasculitis is present in the dermis. The infiltrate contains some lymphocytes in addition to neutrophils"

Edit: Also I've added the two (RMSF and meningococcemia) as infectious vasculitides in my FA, so I've read it either in the Kaplan notes or UWorld, more likely the latter.

 

[thinker]

The most important point that you might wanna remember is that it's non-blanching with the test you do with the glass thingy.. and that's because it's a micro bleed/thrombotic kind of thing.. excuse my use of excessive scientific wording 😛

 

[Phloston]

I would say syphilis is the highest yield vasculitis, quite honestly.