En ung mann med luftveisinfeksjon og ansiktsutslett

Abstract

Berg (born 1957) PhD, is a specialist in infectious diseases and internal medicine and senior consultant. The author has completed the ICMJE form and reports no conflicts of interest.A young man was hospitalised with left-side respiration-dependent chest pain. He had a slightly reduced general condition and fever. It was to be a lengthy stay in hospital, with diagnosis of an unusual cause of pulmonary involvement.A previously healthy man in his late teens was admitted to hospital via the Accident and Emergency Department after twenty-four hours of left-side, respiration-dependent pain. Could the rash developed by the patient after the first penicillin dose be a sign of a disseminated meningococcal disease rather than an allergic reaction? It was not petechial, looked like a drug-induced exanthem, and vanished when the antibiotic was changed. In three studies of a total of 862 patients with meningococcal infection, 37-49 % developed meningitis without shock, 10-18 % shock without meningitis, 7-12 % shock and meningitis and 18-33 % mild meningococcaemia with neither shock nor meningitis (1).The patient was still clinically well, with no neck stiffness or mental deficit, but he had