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Bacterial monarthritis due to Neisseria meningitidis in systemic lupus erythematosus
The Journal of Rheumatology
|January 1, 1981
Abstract:
Two patients with systemic lupus erythematosus developed monarticular infectious arthritis, in which Neisseria meningitidis was recovered from knee synovial fluid. In one instance, the sole manifestation of meningococcal disease was a chronic, indolent, erosive monarthritis. In the second, a febrile, bacteremic illness presented with an acute, septic arthritis.
Insights
Systemic lupus erythematosus patients can develop infectious arthritis caused by Neisseria meningitidis. This meningococcal infection presented as chronic joint erosion in one case and acute septic arthritis in another.
Area of Science:
- Rheumatology
- Infectious Diseases
- Microbiology
Background:
- Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect multiple organ systems.
- Patients with SLE have an increased risk of infections due to their underlying condition and immunosuppressive therapies.
- Septic arthritis is a serious joint infection that requires prompt diagnosis and treatment.
Observation:
- Two patients with SLE presented with monarticular infectious arthritis.
- Neisseria meningitidis was identified as the causative pathogen in the synovial fluid of the affected knee joints in both cases.
- The clinical presentations varied significantly between the two patients.
Findings:
- One patient exhibited a chronic, indolent, erosive monarthritis as the sole manifestation of meningococcal disease.
- The second patient presented with a febrile illness, bacteremia, and acute septic arthritis.
- These findings highlight the diverse clinical spectrum of meningococcal arthritis in SLE patients.
Implications:
- Neisseria meningitidis should be considered in the differential diagnosis of septic arthritis, particularly in immunocompromised individuals such as SLE patients.
- Early recognition and appropriate antimicrobial therapy are crucial for favorable outcomes.
- This case series underscores the importance of considering unusual presentations of common infections in patients with autoimmune diseases.
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