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[An unusual cause of fever: chronic meningococcemia]
1Academisch Ziekenhuis Vrije Universiteit, afd. Kindergeneeskunde, Amsterdam.
Abstract:
In a 14-year old boy admitted because of fever of unknown origin chronic meningococcaemia was diagnosed. He had suffered for the last four months from periods of high fever accompanied by skin rash and arthralgia. Blood culture showed the presence of Neisseria meningitidis. Cerebrospinal fluid culture remained negative. Following the administration of high-dose intravenous benzylpenicillin a prompt resolution of all signs and symptoms was observed. No immunological abnormalities were found. Chronic meningococcaemia can be a--nowadays uncommon--cause of fever of unknown origin.
Insights
Chronic meningococcaemia, a rare cause of prolonged fever, was diagnosed in a boy with symptoms including fever, rash, and joint pain. Treatment with benzylpenicillin led to a full recovery, highlighting its effectiveness against this uncommon infection.
Area of Science:
- Pediatrics
- Infectious Diseases
- Bacteriology
Background:
- Fever of unknown origin (FUO) presents a diagnostic challenge in clinical practice.
- Chronic meningococcaemia is an uncommon but significant cause of persistent febrile illness.
- Neisseria meningitidis is a bacterium typically associated with acute meningitis and sepsis.
Observation:
- A 14-year-old male presented with a four-month history of intermittent high fevers.
- Associated symptoms included a characteristic skin rash and arthralgia (joint pain).
- Blood cultures were positive for Neisseria meningitidis, while cerebrospinal fluid cultures were negative.
Findings:
- The patient was diagnosed with chronic meningococcaemia.
- High-dose intravenous benzylpenicillin therapy resulted in rapid and complete resolution of all clinical signs and symptoms.
- Comprehensive immunological workup revealed no underlying immune deficiencies.
Implications:
- This case underscores the importance of considering chronic meningococcaemia in the differential diagnosis of FUO, even in its less common presentations.
- Prompt diagnosis and appropriate antibiotic treatment, such as benzylpenicillin, are crucial for favorable outcomes.
- Further research into the pathogenesis and diagnostic markers of chronic meningococcaemia may be warranted.