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Acute meningococcaemia complicated by late onset gastrointestinal vasculitis

R A Seaton1, D Nathwani, J Dick

  • 1Infection and Immunodeficiency Unit, Kings Cross Hospital, Dundee, UK.

The Journal of Infection
|October 12, 2000
PubMed

Insights

Late-onset gastrointestinal vasculitis is a rare complication of meningococcaemia (meningococcal infection). This case suggests it may be immunologically mediated, potentially triggered by medication withdrawal or NSAID use.

Area of Science:

  • Infectious Diseases
  • Gastroenterology
  • Immunology

Background:

  • Meningococcal infection (meningococcaemia) typically presents with meningitis or sepsis.
  • Extra-meningeal and non-cutaneous manifestations are recognized but uncommon.
  • Late-onset complications require further investigation.

Observation:

  • A patient with meningococcaemia developed digital gangrene and immunological phenomena.
  • Treatment included iloprost (a prostacycline analogue) and diclofenac (a nonsteroidal anti-inflammatory drug).
  • Withdrawal of iloprost led to abdominal pain and peritonism.

Findings:

  • Laparotomy revealed caecal ischemia and ulceration.
  • Histology confirmed full-thickness mucosal ulceration with vasculitis.
  • The vasculitic process is postulated to be immunologically mediated.

Implications:

  • This case highlights late-onset gastrointestinal vasculitis as a rare complication of meningococcaemia.
  • Potential triggers include immunological phenomena, rebound vasoconstriction after iloprost withdrawal, or NSAID-induced cytotoxicity.
  • Further research is needed to understand the mechanisms and management of this complication.

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