Chronic meningococcemia in a young immunocompetent patient: case report
DOI:
https://doi.org/10.34119/bjhrv9n2-004Keywords:
meningococcemia, Neisseria meningitidis infection, invasive diseaseAbstract
Introduction: Meningococcal disease, caused by Neisseria meningitidis, commonly presents with meningococcemia or meningococcal meningitis. Meningococcemia without meningitis is an often underdiagnosed clinical form of invasive Neisseria meningitidis infection. Case report: We report a case of invasive meningococcal infection with an atypical presentation in the form of meningococcemia without any signs of meningitis or severe sepsis in a seventeen-year-old immunocompetent patient who presented with fever, rash, and arthritis. Definitive diagnosis was made by isolation of meningococci in blood culture. Conclusion: This case highlights the range of clinical features of invasive meningococcal disease. Early recognition of this entity is imperative to allow urgent initiation of appropriate antibiotic therapy, to avoid diagnostic delay, and to prevent potentially serious complications.
References
APARECIDO NUNES, A.; DE JESUS LOPES DE ABREU, A.; CINTRA, O.; CINTRA, M. A. C. T.; BARBOSA COELHO, E.; NOGUEIRA CASTRO DE BARROS, E. Meningococcal disease epidemiology in Brazil (2005–2018) and impact of MenC vaccination. Vaccine, v. 39, n. 3, p. 605–616, 15 jan. 2021. DOI: 10.1016/j.vaccine.2020.11.067. PMID: 33358262.
BERTRAND-GERENTES, I.; FANCHON, L.; COSTE, F. et al. Range of clinical manifestations caused by invasive meningococcal disease due to serogroup W: a systematic review. Infectious Diseases and Therapy, p. 2337–2351, 2023. DOI: 10.1007/s40121-023-00869-z.
CARVALHO, L. A. M. V. de; SANCHEZ, T. E. G.; CARVALHO, N. V. M. de; CARVALHO, S. M. V. de; et al. Meningococcemia without meningitis complicated by purpura fulminans and hearing impairment: a rare case report and review of literature. Brazilian Journal of Health Review, [s. l.], v. 3, n. 4, p. 9712–9718, 2020. DOI: 10.34119/bjhrv3n4-204.
GASPARINI, R.; AMICIZIA, D.; LAI, P. L.; et al. Neisseria meningitidis: pathogenetic mechanisms to overcome the human immune defences. Journal of Preventive Medicine and Hygiene, v. 53, p. 50–55, 2012.
JOSHI, R.; SAROJ, S. D. Survival and evasion of Neisseria meningitidis from macrophages. Medicine in Microecology, v. 17, 100087, 2023. DOI: 10.1016/j.medmic.2023.100087.
LASSO-MALDONADO, C. C.; CORTÉS PACHAJOA, J. A. Meningococcemia without meningitis, starting with gastrointestinal symptoms: case report. International Journal of Innovative Science and Research Technology, v. 7, n. 12, p. 1315–1319, dez. 2022. ISSN 2456-2165. DOI: 10.5281/zenodo.7514509.
MIKUCKI, A.; MCCLUSKEY, N. R.; KAHLER, C. M. The host-pathogen interactions and epicellular lifestyle of Neisseria meningitidis. Frontiers in Cellular and Infection Microbiology, 862935, 22 abr. 2022. DOI: 10.3389/fcimb.2022.862935. PMID: 35531336; PMCID: PMC9072670.
NADEL, S. Treatment of meningococcal disease. Journal of Adolescent Health, v. 59, n. 2 supl., p. S21–S28, ago. 2016. DOI: 10.1016/j.jadohealth.2016.04.013. PMID: 27449146.
PACE, D.; POLLARD, A. J. Meningococcal disease: clinical presentation and sequelae. Vaccine, v. 30, supl., p. B3–B9, 2012.
PRISTA-LEÃO, B.; ALMEIDA, F.; CARVALHO, A. C.; SILVA, S.; SARMENTO, A. Chronic meningococcemia. IDCases, v. 15, e00502, 2 fev. 2019. DOI: 10.1016/j.idcr.2019.e00502. PMID: 30788217; PMCID: PMC6370544.
RAUSCH-PHUNG, E. A.; HALL, W. A.; ASHONG, D. Meningococcal disease (Neisseria meningitidis infection). In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2025. Atualizado em 2 jun. 2025. Disponível em: https://www.ncbi.nlm.nih.gov/books/NBK549849/
SCHULZ, L. P.; GATTI, B.; MILANI, G. P.; LAVA, S. A. G.; LAVAGNO, C.; BIANCHETTI, M. G.; BRONZ, G.; KOTTANATTU, L.; CAMOZZI, P.; FARÉ, P. B. Chronic meningococcal disease: systematic literature review. Journal of Infection and Public Health, 2025.


