Acute ST-segment elevation in Neisseria meningitis

Abstract

Meningitis due to Neisseria meningitidis occurred in a young man. On admission, he was in septic shock and the electrocardiogram revealed convex upwards ST-segment elevation in inferior and lateral leads. Rapid and complete normalisation of the ECG was observed and the patient had a favourable evolution with intensive therapy. The mechanisms of the ECG abnormalities in this disease are unclear. In this patient, ST-segment elevation was probably related to severe transmural ischaemia or prolonged coronary artery spasm as suggested by increase and decrease of cardiac enzymes and transient echocardiographic wall motion abnormalities without pericarditis. However, myocarditis could not be completely ruled out.