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Meningococcemia caused by serogroup W135. Association with hypogammaglobulinemia
Abstract:
Meningococcemia caused by serogroup W135 occurred in four patients during a period of nine months. Three of the patients had hypogammaglobulinemia with normal hemolytic complement levels; the fourth had normal immunoglobulin levels one year after her illness. None of the patients had classic meningitis. One patient had pneumonia; one appeared to have encephalitis with mild meningismus; and two had sepsis without localizing signs or symptoms. Patients with hypogammaglobulinemia are predisposed to the development of meningococcemia, and the incidence of W135 carriage in the population is increasing.
Insights
Meningococcemia caused by serogroup W135 disproportionately affects patients with hypogammaglobulinemia. This study highlights the increasing incidence of W135 carriage and its association with severe infections beyond meningitis.
Area of Science:
- Infectious Diseases
- Immunology
Background:
- Neisseria meningitidis serogroup W135 (MenW135) infections can cause severe disease.
- Hypogammaglobulinemia is a known risk factor for invasive meningococcal disease.
Observation:
- Four cases of meningococcemia due to MenW135 occurred within nine months.
- Three patients presented with hypogammaglobulinemia and normal complement levels.
- One patient had normal immunoglobulin levels one year post-infection.
Findings:
- Meningococcemia presentations included pneumonia, encephalitis, and sepsis, without classic meningitis.
- Patients with hypogammaglobulinemia are susceptible to MenW135 infections.
- Increasing W135 carriage in the general population is noted.
Implications:
- Early recognition of MenW135 in patients with hypogammaglobulinemia is crucial.
- The spectrum of MenW135 disease may be broader than previously recognized.
- Monitoring W135 carriage is important for public health surveillance.