[Post-meningococcal rheumatism (apropos of 3 cases)]

A report is given on 3 cases of arthritis after cerebrospinal meningitis caused by B meningococci, with a relapsing course in 1 case. The observations are compared with the literature and the characteristics of articular manifestations of meningococcal infections are outlined. Three types are distinguished. Type I is characterized by banal arthralgias masked by the symptoms of meningitis. Type II encompasses septic arthritides preceding or concurring with the meningitis and like the latter sensitive to antibiotics. Type III includes postmeningococcal arthritides with sterile articular fluid refractory to antibiotics and showing a spectacular reaction to non-steroid anti-inflammatory drugs. These arthritides constitute a true infective rheumatism, post-meningococcal rheumatism, and should be related to other post-meningococcal manifestations such as pericarditis, myocarditis, cutaneous and ocular changes. All these manifestations are attributed to the production of immune complexes. Postmeningococcal arthritides, whose characteristics are described, may occur after septic meningococcal arthritis or appear as such. The distinction of postmeningococcal rheumatism where only anti-inflammatory treatment is effective might lead to the question whether certain postgonococcal arthritides refractory to antibiotics and responding to anti-inflammatory drugs are not provoked by an immuno-allergic mechanism leading to postgonococcal rheumatism -a nosological entity that has been abandoned possibly too fully and definitively.