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Meningococcaemia causing necrotizing cellulitis associated with acquired complement deficiency after gastric bypass
Zoe Pletschette1, Elodie De Groote2, Wesley Mattheus3
1Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, 808 Route de Lennik, Brussels, Belgium. zoe.pletschette@erasme.ulb.ac.be.
Background:
Neisseria meningitidis has rarely been described as an agent of necrotic soft tissue infection.
Case Presentation:
We report a case of a septic shock with necrotizing cellulitis due to Neisseria meningitidis serogroup W, treated by urgent extensive surgical debridement followed by skin grafts. The invasive meningococcal disease occurred together with a complement deficiency, possibly acquired after bypass surgery that took place 1 year before.
Conclusions:
Necrotic tissue infections should be considered part of the invasive meningococcal diseases spectrum and should prompt clinicians to look for complement deficiencies. Gastric bypass surgery associated malnutrition may be implicated but further verification is needed.
Insights
Neisseria meningitidis can cause severe necrotic soft tissue infections, a rare presentation of invasive meningococcal disease. Early surgical intervention and investigation for complement deficiency are crucial for patient outcomes.
Area of Science:
- Infectious Diseases
- Microbiology
- Surgery
Background:
- Neisseria meningitidis is an uncommon cause of necrotic soft tissue infections.
- Invasive meningococcal disease (IMD) typically presents with meningitis or sepsis.
Observation:
- A case of septic shock with necrotizing cellulitis caused by Neisseria meningitidis serogroup W is presented.
- The patient had a concurrent complement deficiency, potentially acquired post-bypass surgery.
- Treatment involved urgent surgical debridement and skin grafting.
Findings:
- Necrotic soft tissue infection is a potential manifestation of invasive meningococcal disease.
- Complement deficiencies may predispose individuals to severe IMD presentations.
- Gastric bypass surgery and associated malnutrition might play a role, requiring further investigation.
Implications:
- Clinicians should consider necrotic infections in the differential diagnosis of invasive meningococcal disease.
- Screening for complement deficiencies is recommended in patients with severe IMD.
- Further research is needed to confirm the link between gastric bypass surgery and increased IMD risk.