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Primary meningococcal arthritis of the hip in an immunocompetent adolescent
E De Laere1, B Berghs, B Gordts
1Department of Microbiology, Algemeen Ziekenhuis Sint-Jan, Ruddershove 10, B-8000 Brugge, Belgium. e.delaere@skynet.be
Abstract:
The clinical spectrum of meningococcal infection ranges from asymptomatic carriage to fulminant sepsis, with meningitis and septicemia being well-recognized clinical presentations. Meningococcal arthritis as a complication of Neisseria meningitidis infection occurs in about 2-10% of cases, whereas primary meningococcal arthritis (PMA) is a relatively rare phenomenon, even in children. We report here a case of meningococcal infection in an immunocompetent adolescent suffering from acute pain of the right hip as the only symptom upon presentation at the hospital. In such a situation, meningococci are not usually considered as a possible causative agent.
Insights
Meningococcal arthritis is rare, but this case highlights a unique presentation of Neisseria meningitidis causing hip pain in an adolescent. Early recognition is key for timely treatment of this serious infection.
Area of Science:
- Infectious Diseases
- Rheumatology
- Pediatrics
Background:
- Meningococcal infections, caused by Neisseria meningitidis, typically present as meningitis or septicemia.
- Meningococcal arthritis is a known complication, but primary meningococcal arthritis (PMA) is rare, especially in immunocompetent individuals.
Observation:
- A case of an immunocompetent adolescent presenting with acute right hip pain as the sole initial symptom is described.
- The patient's presentation mimicked other hip pathologies, delaying consideration of meningococcal infection.
Findings:
- Neisseria meningitidis was identified as the causative agent in this case of isolated hip arthritis.
- This case underscores that meningococci can present atypically, even without typical signs of meningitis or sepsis.
Implications:
- Highlights the importance of considering less common pathogens like Neisseria meningitidis in cases of acute hip pain, even in immunocompetent patients.
- Suggests that primary meningococcal arthritis may be underdiagnosed due to its varied and non-specific initial presentations.
- Emphasizes the need for a broad differential diagnosis in pediatric hip pain to ensure prompt and appropriate management of infectious causes.