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Primary meningococcal polyarthritis in a young man
Nishant Verma1, Rachna Verma, Seema Sood
1Department of Microbiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029,India.
The National Medical Journal of India
|June 12, 2012
Summary
We describe a rare case of primary meningococcal polyarthritis in a young man. Diagnosis was confirmed using polymerase chain reaction (PCR) despite sterile joint fluid cultures, highlighting PCR
Area of Science:
- Rheumatology
- Infectious Diseases
- Microbiology
Background:
- Meningococcal infections typically manifest as meningitis or sepsis.
- Primary meningococcal polyarthritis is an exceptionally rare presentation.
- Distinguishing infectious arthritis from other inflammatory arthropathies is crucial for timely treatment.
Observation:
- A 19-year-old male presented with polyarthritis.
- Examination of elbow joint fluid revealed Gram-negative diplococci.
- Despite microscopic evidence, joint fluid cultures yielded no bacterial growth.
Findings:
- Diagnosis of primary meningococcal polyarthritis was established.
- Polymerase chain reaction (PCR) targeting the crgA gene of Neisseria meningitidis confirmed the etiology.
- The crgA gene PCR assay proved effective in detecting Neisseria meningitidis in the absence of positive cultures.
Implications:
- This case underscores the importance of considering Neisseria meningitidis in infectious polyarthritis, even with negative cultures.
- Molecular diagnostic methods like PCR are invaluable for identifying pathogens in culture-negative joint effusions.
- Early and accurate diagnosis of meningococcal polyarthritis is essential for appropriate antimicrobial therapy and preventing long-term joint damage.
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