(1):117-119
RESUMOA artrite meningocócica primária, isolada de contexto de sépsis meningocócica, é um fenómeno raro, em especial na idade pediátrica. O atingimento monoarticular é ainda menos frequente nas infecções a Neisseria spp. Apresentamos o caso de lactente de 2 meses de idade, sexo feminino, caucasiana, apresentando quadro de febre elevada com 4 dias de evolução e choro durante a manipulação do membro inferior esquerdo na muda de fralda. Sem sépsis clínica ou analiticamente. Sem vacinação anti-meningocócica prévia. A ecografia articular revelou presença de líquido intra-articular. O exame bacteriológico do drenado purulento por artrotomia foi positivo para Neisseira meningitidis. Apresentou boa resposta à antibioterapia e evolução favorável após a alta. A artrite séptica meningocócica, ainda que rara, constitui uma urgência pediátrica, e é diagnóstico diferencial perante uma criança com quadro febril e queixas articulares. Palavras-chave: Artrite Infecciosa; Infecções Meningocócicas; Lactente; Neisseria meningitidis.
ABSTRACTMeningococcal septic arthritis, ocurring without signs of sepsis, is rare, including at pediatric age. The confinement of infection to a single articulation (monoarticular form) is even rarer in infections by Neisseria spp. We discuss the case of a two month-old caucasian girl, presenting with fever and persistent crying during nappy change. Absence of clinical sepsis was notable. She had had no previous anti-meningococcal immunizations. The ultrasound of the left hip revealed the presence of intra-articular fluid. Culture of the purulent sample after drainage by arthrotomy produced Neisseria meningitidis. She had a good clinical response to the antibiotics. Follow-up showed no sequels. Albeit a rare entity, primary meningococcal arthritis is a mandatory differential diagnosis concerning a feverish child with articular complaints.
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