Droplet precautions in suspected meningococcal disease

What it is

Droplet precautions are the isolation ordered for a defined list of organisms. Neisseria meningitidis, suspected or confirmed, is on that list, and so are pertussis, bacterial meningitis for 24 hours after effective antibiotic therapy, influenza A or B, RSV, which is marked droplet and contact at once, MRSA respiratory infection, mumps, rubella, coxsackie and adenovirus. The mnemonic SPIDERMAN holds the droplet list: sepsis, scarlet fever and streptococcal pharyngitis; parvovirus B19, pneumonia and pertussis; influenza; pharyngeal diphtheria; epiglottitis; rubella; mumps, meningitis, mycoplasma and meningeal pneumonia; and adenovirus.

How it presents

The picture is a young male with high fever and headache that has progressed to neck stiffness and inability to look at bright lights, with no change in mental status. Kernig and Brudzinski signs support the working diagnosis. On the stain the organism is a gram negative diplococcus, that is Neisseria meningitidis.

Two groups are at risk: patients living in close contacts, such as military and college students living in a dorm, and splenectomized patients.