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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.

Abstract

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.