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[Arthritis as complication of acute meningococcal infection]
R R Postema1, J G Brinkman, H J Neyens
1Zuiderziekenhuis, afd. Kindergeneeskunde, Rotterdam.
Abstract:
The incidence of meningococcal disease appears to be increasing in the Netherlands. Numerous complications, mostly involving the central nervous system, have been reported. We focus attention on arthritis by describing the case history of a 2-year-old boy who developed oligoarthritis 8 days after a disease onset characterised by general malaise, fever, signs of meningeal irritation and positive cultures of Neisseria meningitidis in CSF, blood and nasopharynx. The arthritis was probably immune complex mediated. He recovered after antibiotic therapy. There are three forms of arthritis as a complication of meningococcal disease: primary meningococcal arthritis, purulent metastatic arthritis, and immune complex arthritis.
Insights
Meningococcal disease, a serious infection, can lead to arthritis complications. This case highlights immune complex arthritis as a potential outcome following Neisseria meningitidis infection.
Area of Science:
- Infectious Diseases
- Rheumatology
- Pediatrics
Background:
- Meningococcal disease (Neisseria meningitidis) is a significant cause of bacterial meningitis.
- Complications of meningococcal disease often involve the central nervous system, but other manifestations are reported.
- An increasing incidence of meningococcal disease has been observed in the Netherlands.
Observation:
- A 2-year-old boy presented with general malaise, fever, and signs of meningeal irritation.
- Cultures confirmed Neisseria meningitidis in cerebrospinal fluid (CSF), blood, and nasopharynx.
- Eight days after disease onset, the child developed oligoarthritis.
Findings:
- The arthritis was likely an immune complex-mediated complication of meningococcal disease.
- Three distinct forms of arthritis can arise from meningococcal infections: primary meningococcal arthritis, purulent metastatic arthritis, and immune complex arthritis.
- The described case represents immune complex arthritis.
Implications:
- Recognizing diverse complications of meningococcal disease, including arthritis, is crucial for timely diagnosis and management.
- Understanding the pathogenesis of meningococcal arthritis aids in developing targeted treatment strategies.
- This case underscores the importance of considering non-neurological complications in pediatric meningococcal infections.