Meningococcal arthritis and myopericarditis: a case report
File(s)
Published version
Author(s)
Steele, Lloyd
Bechman, Katie
De Barra, Eoghan
Mackworth-Young, C
Type
Journal Article
Abstract
Background:
We report the first adult case of
Neisseria meningitidis W-135
presenting with meningococcal arthritis
and myopericarditis concomitantly, without other classical features of meningococcal disease.
Case presentation:
A 67-year-old Caucasian man presented with acute-onset polyarthralgia, myalgia, and fever. On
examination he had polyarticular synovitis. An electrocardiogram (ECG) demonstrated ST-elevation in leads I, II, III, aVF,
and V2-V6 without reciprocal depression, and a high-sensitivity troponin level was significantly elevated. Cardiac
magnetic resonance (CMR) imaging on day five of admission demonstrated patchy pericardial enhancement.
Neisseria meningitidis W-135
was isolated from both synovial fluid and blood cultures. The clinical outcome was
favourable with intravenous ceftriaxone and myope
ricarditis treatment (colchicine and ibuprofen).
Conclusions:
We conclude that this is a rare case of disseminated
Neisseria meningitidis W-135
presenting with
acute polyarticular septic arthritis and myopericarditis,
without other classical features of systemic meningococcal
disease. The earlier described entity of primary meningococca
l arthritis (PMA) can present in patients with meningococcal
bacteraemia, and may not be distinct from d
isseminated meningococcal disease, but ra
ther an atypical presentation of this.
We report the first adult case of
Neisseria meningitidis W-135
presenting with meningococcal arthritis
and myopericarditis concomitantly, without other classical features of meningococcal disease.
Case presentation:
A 67-year-old Caucasian man presented with acute-onset polyarthralgia, myalgia, and fever. On
examination he had polyarticular synovitis. An electrocardiogram (ECG) demonstrated ST-elevation in leads I, II, III, aVF,
and V2-V6 without reciprocal depression, and a high-sensitivity troponin level was significantly elevated. Cardiac
magnetic resonance (CMR) imaging on day five of admission demonstrated patchy pericardial enhancement.
Neisseria meningitidis W-135
was isolated from both synovial fluid and blood cultures. The clinical outcome was
favourable with intravenous ceftriaxone and myope
ricarditis treatment (colchicine and ibuprofen).
Conclusions:
We conclude that this is a rare case of disseminated
Neisseria meningitidis W-135
presenting with
acute polyarticular septic arthritis and myopericarditis,
without other classical features of systemic meningococcal
disease. The earlier described entity of primary meningococca
l arthritis (PMA) can present in patients with meningococcal
bacteraemia, and may not be distinct from d
isseminated meningococcal disease, but ra
ther an atypical presentation of this.
Date Issued
2017-12-06
Date Acceptance
2017-11-21
Citation
BMC Infectious Diseases, 2017, 17
ISSN
1471-2334
Publisher
BioMed Central
Journal / Book Title
BMC Infectious Diseases
Volume
17
Copyright Statement
© The Author(s). 2017
Open Access
This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver
(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Open Access
This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver
(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Subjects
0605 Microbiology
1103 Clinical Sciences
1108 Medical Microbiology
Microbiology
Publication Status
Published
Article Number
ARTN 751