Arthritis secondary to meningococcal disease: A case series of 7 patients

Area of Science:

• Infectious Diseases
• Rheumatology
• Clinical Microbiology

Background:

• Arthritis secondary to invasive meningococcemia is a rare complication.
• It can manifest as direct septic arthritis or immune-mediated arthritis due to immune complexes.
• Few case series have detailed its clinical characteristics and treatment outcomes.

Purpose of the Study:

• To describe the clinical features and therapeutic outcomes of arthritis associated with invasive meningococcal infections.
• To differentiate between septic and immune-mediated arthritis in this context.
• To inform clinical vigilance regarding joint manifestations of meningococcal disease.

Main Methods:

• A 5-year retrospective multicenter study.
• Inclusion criteria: patients with inflammatory joint symptoms and confirmed Neisseria meningitidis infection.
• Classification: Septic arthritis (positive joint fluid culture) vs. immune-mediated arthritis (onset after disease onset, negative joint fluid culture).

Main Results:

• Seven patients with joint symptoms and meningococcal disease were identified.
• Presentations were typically oligoarticular, with the knee being the most affected joint.
• Five patients had septic arthritis, four had immune-mediated arthritis, and two had both sequentially.
• Immune-mediated arthritis occurred 3-7 days post-meningitis and responded well to NSAIDs.

Conclusions:

• Physicians need to be aware of diverse arthritis presentations linked to invasive meningococcal disease.
• Prompt diagnosis and management are crucial for effective treatment.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) are generally effective for immune-mediated arthritis without complications.