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Primary meningococcal arthritis as a presentation of nodal marginal zone lymphoma

Gemma Ann Joan Harrop1, Jane Tighe1, Alexander MacKenzie1

  • 1Infectious diseases, NHS Grampian, Aberdeen, UK.

BMJ Case Reports
|January 26, 2018
PubMed

Insights

A 68-year-old man with joint pain was diagnosed with meningococcal arthritis and nodal marginal zone lymphoma. This rare presentation highlights the importance of considering systemic disease in infectious arthritis.

Area of Science:

  • Rheumatology
  • Infectious Diseases
  • Hematology

Background:

  • This case report details a rare presentation of infectious arthritis.
  • It emphasizes the diagnostic challenges in patients with concurrent systemic conditions.

Observation:

  • A 68-year-old male presented with acute knee and arm pain, erythema, and swelling.
  • Joint fluid analysis revealed *Neisseria meningitidis* infection.
  • Imaging showed widespread lymphadenopathy, hepatosplenomegaly, and vertebral collapse.

Findings:

  • Blood tests indicated significant hyperproteinemia with an IgM kappa paraprotein.
  • Protein electrophoresis confirmed a high level of monoclonal immunoglobulin.
  • Biopsies revealed lymphoplasmacytic infiltrate in bone marrow and nodal marginal zone lymphoma with plasmacytic differentiation.

Implications:

  • This case underscores the importance of a comprehensive diagnostic approach in complex presentations.
  • It highlights the potential for *Neisseria meningitidis* to cause severe joint disease.
  • The co-occurrence of infection and hematologic malignancy necessitates tailored treatment strategies.
Keywords:
bone and joint infectionsmalignant disease and immunosuppressionmeningitis

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