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Chronic meningococcal disease
I D Jennens1, M O'Reilley, A P Yung
1Fairfield Infectious Diseases Hospital, Vic.
Abstract:
Chronic meningococcal septicaemia is an unusual and infrequently recognised presentation of disease caused by Neisseria meningitidis. Clinical features are immunologically mediated and include fever, rash and arthritis, which may mimic cutaneous vasculitis or reactive gonococcal arthritis. Diagnosis is difficult to confirm as blood cultures commonly do not grow the organism despite weeks of symptoms. Culture of the organism from the nasopharynx may provide supportive evidence for diagnosis. Chronic meningococcaemia should be considered in the differential diagnosis of a cutaneous vasculitis. In the clinical setting of an undiagnosed fever with vasculitic rash and joint symptoms an empirical trial of intravenously administered penicillin should be considered before steroid therapy as a rapid response may simplify the diagnostic dilemma.
Insights
Chronic meningococcal septicaemia, a rare Neisseria meningitidis infection, presents with fever, rash, and arthritis. Early penicillin treatment is recommended for undiagnosed cases mimicking vasculitis.
Area of Science:
- Infectious Diseases
- Rheumatology
- Clinical Microbiology
Background:
- Chronic meningococcal septicaemia is a rare manifestation of Neisseria meningitidis infection.
- Clinical presentation includes fever, rash, and arthritis, mimicking other conditions like vasculitis or gonococcal arthritis.
- Diagnosis is challenging due to negative blood cultures despite prolonged symptoms.