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Group B meningococcal meningitis in India
1Department of Pediatrics, All India Institute of Medical Sciences, New Delhi.
Abstract:
The first case of infection with Group B meningococcus in India is reported. The patient was a 4-month-old boy who presented with meningitis and died within 6 h of admission. Gram stain of CSF showed meningococci and latex particle agglutination test on CSF was strongly positive for Neisseria meningitidis serogroup B. The CSF was also positive for meningococcus by polymerase chain reaction using primers NM1 and NM6, which amplify a 650 bp region of the dihydropteroate synthase (dhps) gene of N. meningitidis.
Insights
The first reported case of Group B meningococcus infection in India involved a 4-month-old boy with meningitis. This rare bacterial meningitis led to rapid fatality, highlighting the aggressive nature of this pathogen.
Area of Science:
- Clinical microbiology and infectious diseases.
- Pediatric infectious disease epidemiology.
- Bacterial meningitis diagnostics.
Background:
- Group B meningococcus (Neisseria meningitidis serogroup B) is a significant cause of bacterial meningitis globally.
- While prevalent in other regions, serogroup B meningococcal infections have been historically rare in India.
- Early and accurate diagnosis is critical for managing meningococcal disease, a potentially fatal infection.
Observation:
- A 4-month-old infant presented with symptoms suggestive of meningitis.
- The patient experienced rapid deterioration and succumbed to the illness within 6 hours of hospital admission.
- Cerebrospinal fluid (CSF) analysis revealed Gram-negative diplococci consistent with meningococci.
Findings:
- Microscopic examination of CSF demonstrated the presence of meningococci.
- Latex particle agglutination testing on CSF yielded a strong positive result for Neisseria meningitidis serogroup B.
- Polymerase chain reaction (PCR) confirmed the presence of N. meningitidis serogroup B using specific primers targeting the dhps gene.
Implications:
- This case represents the first documented instance of Group B meningococcal infection in India.
- The findings underscore the potential emergence and spread of Neisseria meningitidis serogroup B in previously less affected regions.
- Highlights the need for enhanced surveillance and diagnostic capabilities for meningococcal disease in India.