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Case Reports
. 2017 Dec 6;17(1):751.
doi: 10.1186/s12879-017-2845-3.

Meningococcal arthritis and myopericarditis: a case report

Lloyd Steele  1 , Katie Bechman  2 , Eoghan De Barra  2 , Charles Mackworth-Young  2
Affiliations
Case Reports

Meningococcal arthritis and myopericarditis: a case report

Lloyd Steele et al. BMC Infect Dis. .

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 myopericarditis 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 meningococcal arthritis (PMA) can present in patients with meningococcal bacteraemia, and may not be distinct from disseminated meningococcal disease, but rather an atypical presentation of this.

Keywords: Arthritis; Infectious; Meningococcal infections; Neisseria meningitidis; Pericarditis.

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Figures

Fig. 1
Fig. 1
Twelve lead electrocardiogram showing ST-elevation in leads I, II, III, aVF, and V2-V6 without reciprocal depression
Fig. 2
Fig. 2
Cardiac magnetic resonance (CMR) short-axis stack image showing the left (LV) and right ventricles (RV), with pericardial enhancement
See this image and copyright information in PMC

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