Primary meningococcal pericarditis: a disease of adults associated with serogroup C Neisseria meningitidis

Abstract

Pericarditis due to Neisseria meningitidis is usually a consequence of meningeal disease or meningococcemia. This presentation includes a case report of primary meningococcal pericarditis (PMP) and a review of the clinical and epidemiologic features of 15 previously reported cases. All cases have been reported in the past 15 years. Most patients were older teenagers or adults. The median age and age distribution of PMP cases in the United States were significantly greater than that of patients with other meningococcal diseases reported to the Centers for Disease Control (CDC) (P = .005). Similarly, serogroup C N. meningitidis was isolated from 88% of U.S. patients with PMP, compared with isolation from 22% of patients with other meningococcal diseases reported to the CDC (P = .00016). Culture of pericardial fluid usually yielded meningococci, and most patients presented with signs and symptoms typical of purulent pericarditis. A positive pericardial culture was associated with the development of cardiac tamponade (P = .03). With appropriate antibiotic treatment and drainage of pericardial fluid when indicated, all 16 patients survived and experienced few or no sequelae.