An Unexpected Fever Post Serogroup B Meningococcal Sepsis

Area of Science:

• Pediatrics
• Infectious Diseases
• Rheumatology

Background:

• Invasive meningococcal group B infection can have severe sequelae.
• Kawasaki disease (KD) is an acute febrile vasculitis primarily affecting young children.
• Macrophage activation syndrome (MAS) is a severe, life-threatening hyperinflammation.

Observation:

• A 2-year-old child presented with invasive meningococcal group B infection.
• The child subsequently developed Kawasaki disease (KD) complicated by macrophage activation syndrome (MAS).
• This sequence suggests a potential link between meningococcal sepsis and KD etiology.

Findings:

• The case supports the bacterial toxin-induced theory for Kawasaki disease.
• Persistent or relapsing fever during or after severe infections warrants suspicion for KD.
• Intravenous immunoglobulin is the standard initial treatment for KD.

Implications:

• Refractory KD complicated by MAS may benefit from corticosteroid therapy.
• Corticosteroids demonstrated prompt fever resolution and clinical improvement in this case.
• Clinicians should consider KD in children with recurrent fevers post-severe infection, particularly meningococcal sepsis.