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[Recurrent fever and skin eruption revealing chronic meningococcemia]
1Service de médecine interne, hôpital Saint-Antoine, Assistance publique-Hôpitaux de Paris, université Pierre-et-Marie-Curie-Paris, 184, rue du Faubourg-Saint-Antoine, 75012 Paris cedex, France.
Introduction:
Chronic meningococcemia is an unusual clinical presentation within the spectrum of infections due to Neisseria meningitidis.
Case Report:
We report a 32-year-old man who presented with a 15-day history of fever and maculopapular skin rash, in the absence of meningeal irritation or severe sepsis manifestation. Blood culture identified N. meningitidis. Clinical course was uneventful after antibiotic treatment was initiated.
Conclusion:
Early diagnosis of chronic meningococcemia is crucial for optimal management of the patient and his/her contacts. Such a diagnosis should be suspected in the presence of the characteristic clinical triad (recurrent fever, skin rash and arthralgia), and this clinical presentation should be distinguished from systemic vasculitis as inadequate prescription of corticosteroids may be deleterious.
Insights
Chronic meningococcemia, a rare Neisseria meningitidis infection, presents with fever and rash. Early diagnosis is key for effective treatment and preventing complications.
Area of Science:
- Infectious Diseases
- Bacteriology
- Clinical Medicine
Background:
- Neisseria meningitidis can cause chronic meningococcemia, an uncommon clinical manifestation.
- This condition is distinct from acute meningococcal sepsis and meningitis.
Observation:
- A 32-year-old male presented with a 15-day history of recurrent fever and a maculopapular rash.
- The patient lacked signs of meningeal irritation or severe sepsis.
Findings:
- Blood cultures confirmed the presence of Neisseria meningitidis.
- The patient recovered fully after initiating antibiotic therapy.
Implications:
- Prompt diagnosis of chronic meningococcemia is vital for patient and contact management.
- Recognizing the triad of fever, rash, and arthralgia aids diagnosis and differentiates from vasculitis, avoiding harmful corticosteroid use.
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