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Chronic meningococcemia
Beatriz Prista-Leão1,2,3, Francisco Almeida1,2,3, Ana Cláudia Carvalho1,2,3
1Infectious Diseases Department, Centro Hospitalar Universitário de São João, Alameda Professor Hernani Monteiro, 4200-319, Porto, Portugal.
Abstract:
The spectrum of Neisseria meningitidis-associated clinical entities involves mild forms of disease, without neurological involvement or sepsis, and asymptomatic carrier states. Rarely, N. meningitidis bacteremia can be associated with a prolonged fever with or without arthritis, which we designate as chronic meningococcemia. Chronic meningococcemia is an uncommon entity, usually associated to serogroup B N. meningitidis. Diagnosis is frequently delayed as blood cultures collected outside febrile periods can be negative. We present a case of chronic meningococcemia in a 22-year-old woman with no relevant clinical background, presenting with fever, arthralgia and exanthem. Due to the potential for progression to more severe disease and the risk of N. meningitidis transmission and development of secondary cases, a high degree of clinical suspicion is required to ensure prompt recognition and adequate treatment. Our patient had a favorable outcome probably due to early recognition and adequate treatment, which is critical for the resolution of the disease without complications.
Insights
Chronic meningococcemia, a rare prolonged fever caused by Neisseria meningitidis, often presents with arthritis and rash. Early diagnosis and treatment are crucial for favorable outcomes and preventing transmission.
Area of Science:
- Infectious Diseases
- Bacteriology
- Clinical Medicine
Background:
- Neisseria meningitidis causes a spectrum of diseases, from mild infections to asymptomatic carriage.
- Chronic meningococcemia is a rare manifestation of N. meningitidis bacteremia, typically associated with serogroup B.
- Diagnosis can be challenging due to intermittent bacteremia, leading to delayed recognition.
Observation:
- A case of chronic meningococcemia in a young woman presented with prolonged fever, arthralgia, and exanthem.
- The patient had no significant prior medical history.
- Blood cultures were negative outside of febrile episodes, highlighting diagnostic difficulties.
Findings:
- The patient's presentation included fever, joint pain, and a skin rash.
- Prompt recognition and appropriate treatment led to a favorable outcome.
- Early intervention is critical for resolving chronic meningococcemia without complications.
Implications:
- High clinical suspicion is necessary for timely diagnosis of chronic meningococcemia.
- Effective treatment can prevent progression to severe meningococcal disease.
- Prompt management reduces the risk of N. meningitidis transmission and secondary cases.
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