The main problem is hypovolaemia secondary to fluid leaking out from the intravascular space. Treatment relies on infusion of large amounts of colloid.
In addition, endotoxaemia may cause renal vasoconstriction, despite peripheral vasodilation.
Clinical pictures of meningococcal septicaemia
An early rash:
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A more advanced stage:
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Pictures taken from the Meningitis Research web site at http://www.meningitis.ca/en/MeningococcalDisease