Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
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.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

Not applicable

Consent for publication

Patient consent for case report publication in journal and has signed consent form.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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

References

    1. Public Health England . Meningococcal reference unit user manual. Manchester: Public Health England; 2015.
    1. Stephens DS, Greenwood B, Brandtzaeg P. Epidemic meningitis, meningococcaemia, and Neisseria meningitidis. Lancet. 2007;369(9580):2196–2210. doi: 10.1016/S0140-6736(07)61016-2. - DOI - PubMed
    1. Rouphael NG, Stephens DS. Neisseria meningitidis: biology, microbiology, and epidemiology. Methods Mol Biol. 2012;799:1–20. doi: 10.1007/978-1-61779-346-2_1. - DOI - PMC - PubMed
    1. Cartwright KA, Stuart JM, Jones DM, Noah ND. The Stonehouse survey: nasopharyngeal carriage of meningococci and Neisseria lactamica. Epidemiol Infect. 1987;99(3):591–601. doi: 10.1017/S0950268800066449. - DOI - PMC - PubMed
    1. Pace D, Pollard AJ. Meningococcal disease: clinical presentation and sequelae. Vaccine. 2012;30(Suppl 2):B3–B9. doi: 10.1016/j.vaccine.2011.12.062. - DOI - PubMed

Publication types

MeSH terms