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Review
. 2023 Oct;12(10):2337-2351.
doi: 10.1007/s40121-023-00869-z. Epub 2023 Sep 26.

Range of Clinical Manifestations Caused by Invasive Meningococcal Disease Due to Serogroup W: A Systematic Review

Isabelle Bertrand-Gerentes  1 , Laurent Fanchon  2 , Florence Coste  1 , Richard E Glover  3 , Tamazoust Guiddir  4 , Muhamed-Kheir Taha  5
Affiliations
Review

Range of Clinical Manifestations Caused by Invasive Meningococcal Disease Due to Serogroup W: A Systematic Review

Isabelle Bertrand-Gerentes et al. Infect Dis Ther. 2023 Oct.

Abstract

Introduction: Invasive meningococcal disease (IMD) due to serogroup W meningococci (MenW) is consistently reported with atypical clinical manifestations, including gastrointestinal symptoms, bacteremic pneumonia, and septic arthritis. We undertook a systematic review of the literature for a comprehensive assessment of the clinical presentation of IMD caused by MenW.

Methods: PubMed and Embase databases were searched from inception to June 2022 using a combination of MeSH terms and free text for articles that reported symptoms and signs of MenW IMD, and associated manifestations.

Results: The most commonly reported symptoms identified included: fever (range 36-100% of cases), nausea and/or vomiting (range 38-47%), vomiting (range 14-68%), cough (range 7-57%), sore throat (range 13-34%), headache (range 7-50%), diarrhea (range 8-47%), altered consciousness/mental status (range 7-38%), stiff neck (range 7-54%), and nausea (range 7-20%). Sepsis (range 15-83% of cases) was the most commonly reported manifestation followed by meningitis (range 5-72%), sepsis and meningitis (range 6-74%), bacteremic pneumonia (range 4-24%), arthritis (range 1-15%), and other manifestations (e.g., pharyngitis/epiglottitis/supraglottitis/tonsillitis/conjunctivitis; range 1-24%). The case fatality rates ranged from 8-40%, and among the survivors 4-14% had long-term sequelae.

Conclusions: Clinicians need to be aware of the nonspecific symptoms and signs of IMD, as well as of the atypical manifestations in regions where MenW is known to circulate to ensure timely diagnoses and treatment.

Keywords: Invasive meningococcal disease; Serogroup W; Symptoms.

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Conflict of interest statement

I.B-G., L.F., and F.C. are employees of Sanofi and may hold shares and/or stock options in the company. R.E.G. is an employee of inScience Communications, Springer Healthcare Ltd, UK, which was contracted by Sanofi to undertake the literature search and provide editorial assistance. M.K.T. performs contract work for the Institut Pasteur funded by GSK, Pfizer, and Sanofi, and has a patent (NZ630133A) with GSK “vaccines for serogroup X meningococcus” issued.

Figures

Fig. 1
Fig. 1
PRISMA flowchart for the selection of articles included
Fig. 2
Fig. 2
Age affected over time: scatterplot of the case age and year of publication (single case studies or studies that reported data for ≤ 10 cases). Each dot represents an individual case
See this image and copyright information in PMC

References

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