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Fulminant seems to mead rapid. There is however some articles with both phrases: "fulminant meningococcecemia" (about 5000 Google matches) and "acute meningococcecemia" (about 3000 Google matches).

I am thinking Neisseria meningitidis and its pathogenesis

Portal entry nasopharynx (pili)-> attach epithelium cells -> bloodstream (bacteremia); upper respiratory tract infection -symptoms; may be asymptomatic in transient flora; fulminant meningocococcemia (regardless of meningitis)

What is the difference between the two diseases?

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When we say "Fulminant meningococcemia" we mean failure of adrenal glands due to haemorrhage of infectious origin, or Waterhouse–Friderichsen syndrome

and acute is related to time of signs appearance, opposed to chronic disease.

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  • $\begingroup$ Can we say that all fulminant diseases are acute? In this case, the fulminant disease seems to acute. $\endgroup$
    – Léo Léopold Hertz 준영
    Commented Feb 21, 2014 at 15:53
  • $\begingroup$ in medicine there are not 100%, so we only can say that most of fulminant infections are acute, but sometimes chronic bacteremia or chronic wounds can lead to fulminant deterioration in the host $\endgroup$
    – Ilan
    Commented Feb 21, 2014 at 16:35
  • $\begingroup$ This answer is incorrect. Fulminant does not refer specifically to adrenal hemorrhage. It's a general adjective describing the explosive course of a disease process. $\endgroup$
    – De Novo
    Commented Sep 14, 2018 at 21:24
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Both fulminant and acute are adjectives that describe a disease course. The previous answer by @ilan is incorrect. Fulminant does not specifically refer to adrenal failure, despite the association between meningococcemia (which often has a fulminant course) and adrenal hemorrhage.

Fulminant relates to onset, speed of progression, and severity. A fulminant disease process is sudden, rapidly progressing and very severe. Diseases processes described as fulminant are often lethal if not immediately treated. Meningococcal bacteremia, classically described as purpura fulminans, is one example.

Acute relates mostly to onset. Here the earlier answer by @ilan is correct. Acute, as opposed to chronic, refers to a disease process with a short course, or a short term phase of a disease process with a longer course (as in an acute exacerbation of a chronic disease process).

All fulminant disease processes are acute, by definition. When referring to bacteremia with Neisseria meningitidis, the use of the descriptor acute or fulminant does not indicate a different disease. So I suppose the direct answer to this question is that there is no specific difference between fulminant and acute meningococcemia. They are not separate diseases, and both terms could correctly be used to refer to the same case.

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