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Atypical presentation of invasive meningococcal disease caused by serogroup W meningococci
C Stinson1, C Burman1, J Presa2
1Medical Development & Scientific and Clinical Affairs, Pfizer Inc, 500 Arcola Rd, Collegeville, PA19426, USA.
Abstract:
Neisseria meningitidis, a gram-negative diplococcus, is typically an asymptomatic coloniser of the oropharynx and nasopharynx. Passage of N. meningitidis into the bloodstream can cause invasive meningococcal disease (IMD), a potentially life-threatening illness with rapid onset that generally presents as meningitis, septicemia or both. Serogroup W IMD has been increasing in prevalence in recent years, and observations suggest that it may present with atypical signs and symptoms. Herein, a literature search was performed to identify trends in atypical serogroup W IMD presentation in order to review those that are most prevalent. Findings indicate that the most prevalent atypical presentations of serogroup W IMD include acute gastrointestinal (GI) symptoms, septic arthritis and bacteremic pneumonia or severe upper respiratory tract infection, notably epiglottitis. Atypical clinical presentation is associated with higher case fatality rates and can lead to misdiagnoses. Such risks highlight the need for clinicians to consider IMD in their differential diagnoses of patients with acute GI symptoms, septic arthritis or bacteremic pneumonia, primarily in regions where serogroup W is prevalent.
Insights
Serogroup W invasive meningococcal disease (IMD) can present with unusual symptoms like gastrointestinal issues, septic arthritis, or pneumonia. Recognizing these atypical signs is crucial for timely diagnosis and improved outcomes.
Area of Science:
- Microbiology
- Infectious Diseases
- Epidemiology
Background:
- Neisseria meningitidis is a common bacterium colonizing the upper respiratory tract.
- Invasive meningococcal disease (IMD) arises when the bacterium enters the bloodstream, causing severe illness like meningitis or septicemia.
- Serogroup W IMD is emerging and may exhibit atypical clinical presentations.
Purpose of the Study:
- To identify and review the most prevalent atypical presentations of serogroup W IMD.
- To understand the clinical trends associated with serogroup W IMD.
Main Methods:
- A literature search was conducted.
- The search focused on identifying trends in atypical serogroup W IMD presentations.
Main Results:
- The most common atypical presentations include acute gastrointestinal symptoms, septic arthritis, and bacteremic pneumonia or severe upper respiratory tract infections like epiglottitis.
- Atypical presentations are linked to increased case fatality rates and potential misdiagnoses.
Conclusions:
- Clinicians should consider IMD in differential diagnoses for patients presenting with acute GI symptoms, septic arthritis, or bacteremic pneumonia, especially in serogroup W prevalent areas.
- Early recognition of atypical IMD presentations is vital for reducing mortality and morbidity.
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