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[Chronic meningococcemia. A review and a report of 4 cases]
1Medicinsk-epidemisk afdeling A. Marselisborg Hospital, Arhus.
Abstract:
Four cases of chronic meningococcacemia (CM) are described. The diagnosis was based on recurring fever, exanthema, arthralgia/arthritis and positive blood culture with Neisseria meningitidis. The meningococcal antibody-test (MAT) was positive in all of the three patients tested. None of the patients had positive throat culture for Neisseria meningitidis. All patients had leucocytosis during the febrile periods. The symptoms lasted for 5-150 days before the diagnosis was made. These findings are discussed in relation to the literature.
Insights
Chronic meningococcemia (CM) is a rare infection caused by Neisseria meningitidis. Diagnosis requires recurring fever, rash, joint pain, and positive blood cultures, even without throat infection.
Area of Science:
- Infectious Diseases
- Microbiology
- Clinical Medicine
Background:
- Chronic meningococcemia (CM) is an uncommon presentation of Neisseria meningitidis infection.
- Distinguishing CM from other febrile illnesses can be challenging due to its varied symptoms.
Observation:
- Four cases of CM are presented, characterized by recurrent fever, exanthema, and arthralgia/arthritis.
- Positive blood cultures for Neisseria meningitidis confirmed the diagnosis in all cases.
- Meningococcal antibody-test (MAT) was positive in tested patients, while throat cultures were negative.
Findings:
- Leukocytosis was consistently observed during febrile episodes.
- Symptoms persisted for extended periods (5-150 days) prior to diagnosis.
- The diagnostic criteria included recurring fever, rash, joint pain, and positive blood cultures.
Implications:
- Highlights the importance of considering CM in patients with prolonged, non-specific febrile symptoms.
- Suggests that blood cultures and MAT are crucial for diagnosing CM, especially when throat cultures are negative.
- Emphasizes the need for increased awareness among clinicians regarding this rare but serious infection.