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Published on: February 23, 2014
[Chronic meningococcemia: 3 cases in the immunocompetent child]
E Grouteau1, S Chaminade, C Karsenty
1Service de médecine infantile A, infectiologie, rhumatologie et neurologie pédiatriques, CHU Purpan, Toulouse, France.
Unlabelled:
Chronic meningococcemia is a part of extra meningeal manifestations of meningococcal disease. Its diagnosis can be difficult because of lack of sensitivity of blood cultures.
Case Report:
Three cases, concerning immunocompetent children, respectively aged of 14, 10 and 4 years are reported. The clinical course was characterized by recurrent fever, inflammatory joint manifestations and diffuse maculopapules secondary centered by petechiae. Microbiological findings revealed in one case a positive throat culture and presence of meningococcal soluble antigens in blood and urine. In the other two cases, diagnosis was done after done after positive blood culture at the 7th, and 13th days of course.
Conclusion:
The diagnosis should be considered in any children with a prolonged, recurrent fever and cutaneous and joint manifestations even if blood cultures remain negative. The response to therapy by usual antimeningococcal antibiotics is dramatic and curative while a prolonged untreated course may be complicated by metastatic infection.
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