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Published on: October 20, 2013
Meningococcal Septic Oligoarthritis: An Unusual Presentation Revealing Concurrent Multiple Myeloma
Luís A Rocha1, Luciana Silva1, João Miranda1
1Internal Medicine, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, PRT.
Abstract:
Meningococcal invasive disease is rare in immunocompetent hosts but may occur in patients with risk factors. Septic arthritis is an uncommon form of presentation and is usually due to surgical colonization or hematogenous dissemination. We present a case of a 73-year-old woman, who recently underwent knee replacement surgery, presenting with right knee and left shoulder pain, swelling, and reduced range of motion. Antibiotic therapy was promptly initiated, and the identification of invasive meningococcal disease with septic arthritis was possible through blood cultures and synovial fluid analysis.
Insights
Invasive meningococcal disease is rare but can present as septic arthritis, particularly after joint replacement surgery. Prompt diagnosis via blood and synovial fluid analysis is crucial for effective antibiotic treatment.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Orthopedic Surgery
Background:
- Invasive meningococcal disease (IMD) is uncommon in immunocompetent individuals.
- Septic arthritis is a rare manifestation of IMD, often linked to surgical site infection or bloodstream spread.
- Risk factors can increase susceptibility to IMD.
Observation:
- A 73-year-old female patient presented with acute right knee and left shoulder pain, swelling, and limited mobility.
- The patient had recently undergone knee replacement surgery.
- Symptoms suggested a potential infectious or inflammatory process.
Findings:
- Blood cultures and synovial fluid analysis confirmed invasive meningococcal disease.
- The patient's septic arthritis was directly attributed to Neisseria meningitidis.
- Diagnostic workup identified the causative pathogen efficiently.
Implications:
- This case highlights the importance of considering IMD in patients with septic arthritis, especially post-orthopedic surgery.
- Early identification and targeted antibiotic therapy are critical for favorable outcomes.
- Highlights a rare but serious complication following joint replacement.
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