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An uncommon presentation: chronic meningococcaemia associated with cholestatic hepatitis in a Turkish child

Mehmet Totan1, Gulcan Yildiz, Ayhan Gazi Kalayci

  • 1Department of Pediatrics, Ondokuz Mayis University Faculty of Medicine, Samsun,Turkey. mtotan@omu.edu.tr

Journal of Tropical Pediatrics
|November 13, 2004
PubMed

Insights

Chronic meningococcaemia, a rare Neisseria meningitidis infection, can manifest with cholestatic hepatitis in children. This case highlights an unusual presentation and successful treatment of this rare pediatric condition.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Hepatology

Background:

  • Chronic meningococcaemia is an exceptionally rare clinical presentation of invasive Neisseria meningitidis infection.
  • Invasive meningococcal disease typically presents acutely, making chronic forms exceedingly uncommon.

Observation:

  • A 9-year-old girl presented with symptoms including fever, headache, arthralgia, and a maculopapular rash.
  • Blood cultures confirmed the presence of Neisseria meningitidis, establishing the diagnosis of chronic meningococcaemia.
  • Elevated liver function tests indicative of cholestatic hepatitis were observed four days post-admission.

Findings:

  • The patient's Neisseria meningitidis infection was successfully treated, leading to complete resolution of symptoms.
  • This case represents the first reported instance of Neisseria meningitidis infection causing cholestatic hepatitis in a child.
  • The clinical course demonstrated a rare association between chronic meningococcaemia and hepatic dysfunction.

Implications:

  • This case expands the known clinical spectrum of Neisseria meningitidis infections.
  • It underscores the importance of considering unusual presentations of meningococcal disease in pediatric patients.
  • Further research may elucidate the mechanisms by which Neisseria meningitidis can induce cholestatic hepatitis.

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