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A case of invasive meningococcal disease presenting as myopericarditis

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Title: A case of invasive meningococcal disease presenting as myopericarditis
Authors: Durkin, S
Britton, C
Cooke, G
Mehta, R
Item Type: Journal Article
Abstract: Background Neisseria meningitidis is a universally-feared Gram negative diplococcus, and infection confers high rates of morbidity and mortality despite effective antimicrobial therapy. Invasive meningococcal disease most commonly presents with meningococcaemia or meningococcal meningitis. Case report 72-year-old female, previously fit and well, was admitted with chest pain, and associated breathlessness and diarrhoea. The clinical picture was of a myopericarditis. Results Initial electrocardiogram (ECG) changes and elevated troponin were consistent with myopericarditis. Neisseria meningitidis W135 was cultured from blood, and subsequently from cerebrospinal fluid (CSF). Leptomeningeal meningitis and ventriculitis was evident on magnetic resonance imaging (MRI) of the brain. Treatment was commenced with intravenous ceftriaxone. The clinical course was complicated by pneumonia, influenza A infection, and fatal pulmonary embolism. Conclusions This case demonstrates the range of clinical features of invasive meningococcal disease, highlighting in particular that meningococcal bacteraemia can present clinically as myopericarditis, which may be present in a substantial proportion of cases. Prompt antimicrobial therapy, as well as an awareness of potential complications, are paramount in the clinical management of meningococcal myopericarditis.
Issue Date: Nov-2021
Date of Acceptance: 1-Jul-2021
URI: http://hdl.handle.net/10044/1/90641
DOI: 10.1016/j.clinpr.2021.100082
ISSN: 2590-1702
Publisher: Elsevier
Journal / Book Title: Clinical Infection in Practice
Volume: 12
Copyright Statement: © 2021 Published by Elsevier Ltd on behalf of British Infection Association. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Publication Status: Published
Article Number: 100082
Online Publication Date: 2021-07-09
Appears in Collections:Department of Infectious Diseases
Faculty of Medicine



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