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Pathogenesis and diagnosis of human meningococcal disease using immunohistochemical and PCR assays

Jeannette Guarner1, Patricia W Greer, Anne Whitney

  • 1Infectious Disease Pathology Activity, Division of Viral Rickettsial Diseases, National Centers for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.

American Journal of Clinical Pathology
|October 20, 2004
PubMed

Insights

Fatal sepsis caused by Neisseria meningitidis can be diagnosed and serogrouped using immunohistochemical analysis and PCR on formalin-fixed tissues. These methods reveal meningococcal distribution and pathogenesis in fatal cases.

Area of Science:

  • Infectious Diseases
  • Pathology
  • Microbiology

Background:

  • Neisseria meningitidis is a primary cause of fatal sepsis.
  • Rapid diagnosis is challenging in fulminant cases where cultures are unavailable.

Purpose of the Study:

  • To evaluate immunohistochemical analysis and real-time PCR for diagnosing Neisseria meningitidis in formalin-fixed tissues.
  • To determine the distribution of N. meningitidis and its antigens in fatal and surviving cases.
  • To enable serogroup determination for improved understanding of meningococcal disease.

Main Methods:

  • Immunohistochemical assay applied to formalin-fixed tissue samples from 14 patients.
  • Histopathologic examination of tissues from fatal cases.
  • Real-time PCR for serogroup determination on formalin-fixed samples.

Main Results:

  • Histopathology revealed interstitial pneumonitis, hemorrhagic adrenal glands, myocarditis, meningitis, and thrombi in fatal cases.
  • Immunohistochemistry detected meningococci and antigens within immune cells and extracellularly.
  • PCR successfully serogrouped N. meningitidis in 11 of 14 cases (8 C, 2 Y, 1 B).

Conclusions:

  • Immunohistochemical analysis and PCR are effective for diagnosing and serogrouping N. meningitidis in formalin-fixed tissues.
  • These techniques provide insights into the tissue distribution and pathogenesis of meningococcal disease.
  • Diagnosis is feasible even when cultures are unobtainable in fulminant cases.

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