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[Fulminant meningococcemia presenting as a gastroenteritis-like syndrome]

A Hussein1, Y Naschitz, D Yeshurun

  • 1Depts. of Emergency Medicine and of Medicine A, Bnai Zion Medical Center and Bruce Rapport Faculty of Medicine, Haifa.

Harefuah
|June 23, 2001
PubMed

Insights

Gastroenteritis symptoms like diarrhea and abdominal pain can signal a rare but serious Neisseria meningitidis infection (meningococcemia) in adults. This case highlights the importance of considering meningococcemia in elderly patients presenting with such symptoms, even if rare.

Area of Science:

  • Infectious Diseases
  • Internal Medicine
  • Gastroenterology

Background:

  • Neisseria meningitidis (meningococcus) commonly causes meningitis or pharyngitis globally.
  • Gastrointestinal symptoms are an atypical presentation of meningococcemia, primarily observed in children.
  • Literature review identified only three prior adult cases of meningococcal gastroenteritis, all in young adults.

Observation:

  • An 80-year-old woman presented with fever, diarrhea, and abdominal pain.
  • Meningococcus infection was suspected and subsequently confirmed by blood culture.
  • Despite intensive treatment with ceftriaxone and gentamicin, the patient did not improve.

Findings:

  • The patient succumbed to the infection 40 hours after admission.
  • This case represents an extremely rare presentation of meningococcemia in an elderly adult.
  • The clinical presentation mimicked a typical gastroenteritis syndrome.

Implications:

  • Clinicians should consider meningococcemia in the differential diagnosis of unexplained gastroenteritis, particularly in elderly patients.
  • Early recognition and treatment of meningococcemia are crucial due to its potential for rapid progression and high mortality.
  • This case underscores the variability of Neisseria meningitidis presentation across different age groups.

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