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A Fatal Case of Invasive Infection Caused By W135 Neisseria meningitidis in a Vaccinated French Soldier
Sandrine Duron1, Christophe Martinaud2, David Lacassagne2
1French Armed Forces Center for Epidemiology and Public Health, Camp militaire de Sainte Marthe, GSBdD Marseille Aubagne, 111 Avenue de la Corse, BP 40026, 13568 Marseille Cedex 02, France.
Abstract:
We report on the case of fatal "purpura fulminans" caused by Neisseria meningitidis W135 that occurred in a young French soldier vaccinated a few months earlier with the tetravalent conjugate vaccine ACYW135. Biological investigations revealed adequate titers of postvaccination antibodies against serogroups A, C, and W135 and led to the post-mortem diagnosis of a complete C7 complement deficiency. Late complement component deficiency is a well-known risk factor of meningococcal diseases, but usually exposes to recurrent mild infections, whereas severe invasive meningococcal diseases are more likely to occur among properdin-deficient patients. Awareness of the potentially life-threatening nature of late complement component deficiency should lead to improved diagnosis among young people, especially when past medical history reveals recurrent mild infections.
Insights
A fatal case of meningococcal disease occurred in a vaccinated soldier with a C7 complement deficiency. This highlights the severe risks associated with complement deficiencies and meningococcal infections.
Area of Science:
- Immunology
- Infectious Diseases
- Genetics
Background:
- Neisseria meningitidis W135 can cause severe invasive infections.
- Vaccination with tetravalent conjugate vaccines (ACYW135) is standard for prevention.
- Complement deficiencies are known risk factors for meningococcal disease.
Observation:
- A young soldier, vaccinated against meningococcal serogroups A, C, Y, and W135, developed fatal purpura fulminans.
- Post-vaccination antibody titers were adequate, indicating vaccine effectiveness.
- Post-mortem diagnosis revealed a complete C7 complement deficiency.
Findings:
- Complete C7 complement deficiency was identified as the underlying risk factor.
- Severe invasive meningococcal disease can occur despite adequate antibody titers.
- Late complement component deficiencies, particularly C7, can lead to life-threatening outcomes.
Implications:
- Early diagnosis of complement deficiencies is crucial, especially in young individuals with a history of recurrent infections.
- Complement deficiencies represent a significant risk factor for severe meningococcal disease, even in vaccinated populations.
- Increased awareness and diagnostic vigilance for complement deficiencies are needed to prevent severe meningococcal infections.
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