Immune complex associated complications in the subacute phase of meningococcal disease: incidence and literature review

Goedvolk, C A; Rosenstiel, Inès A. von; Bos, Albert P.

doi:10.1136/adc.88.10.927

Cited by 60 publications

(39 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Arthritis with meningococcal disease may also occur and frequently manifest as an immune-mediated form with sterile effusions affecting large joints, often with polyarthritis and fever 2,3,10 . Arthritis onset shows up between one to 12 days after the initial illness 12 .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Infection and immune-mediated meningococcal-associated arthritis: combination features in the same patient

Ibrahim

Carvalho

Moura

et al. 2012

Rev. Inst. Med. trop. S. Paulo

View full text Add to dashboard Cite

SUMMARYWe present a case of a 16-year-old male patient with sudden-onset, rash, arthritis and meningitis by Neisseria meningitidis one week after an acute upper respiratory infection. On the 10 th day of treatment followed by neurological and arthritis clinical improvement, he presented once again a tender and swollen left knee with a moderate effusion, and active and passive range of motion was severely limited secondary to pain, and when he was submitted to surgical drainage and synovial fluid analysis he showed inflammatory characteristics. A non-steroidal anti-inflammatory drug was taken for five days with complete improvement of symptoms. The case is notable for its combination of features of septic and immune-mediated arthritis, which has rarely been reported in the same patient.

show abstract

Section: Discussionmentioning

confidence: 99%

“…The knee MRI revealed a moderate articular effusion and a severe tenosynovitis associated to oedema and inflammatory periarticular process and popliteal lymph nodes. A second arthroscopic knee washout yielded sero-sanguineous fluid with a cell count of 30,100/mm 3 . No bacteria were found at Gram stain.…”

mentioning

confidence: 99%

Infection and immune-mediated meningococcal-associated arthritis: combination features in the same patient

Ibrahim

Carvalho

Moura

et al. 2012

Rev. Inst. Med. trop. S. Paulo

View full text Add to dashboard Cite

show abstract

“…These reactive inflammatory complications are associated with type 3 immune complex hypersensitivity reactions and inflammatory cytokines. The risk factors for the development of these complications include severe disease, older age (more frequent in adolescents and adults), and a high inflammatory state during the primary infection (6). Although secondary reactions usually occur 6-16 days after the primary infection (6), our patient developed these complications after approximately 1 month.…”

mentioning

confidence: 87%

“…N. meningitidis serogroup W-135 causes both pyogenic and reactive pericarditis and arthritis more frequently than other serogroups (7). Although reactive pericarditis and arthritis have also been reported in N. meningitidis serogroup C infections (6), such complications appear to depend on ST or electrophoretic type (ET) and are reported to be associated with the ST-11/ET-37 clonal complex (8). However, it remains unknown why the ST-11 strain is associated with an increased frequency of extrameningeal complications.…”

mentioning

confidence: 90%

Meningococcemia due to the 2000 Hajj-Associated Outbreak Strain (Serogroup W-135 ST-11) with Immunoreactive Complications

et al. 2013

View full text Add to dashboard Cite

SUMMARY:We present the first reported case of systemic infection with Neisseria meningitidis serogroup W-135 sequence type (ST)-11 in Japan. A 44-year-old woman presented with high fever, sore throat, and fatigue and was diagnosed with N. meningitidis bacteremia. The causative strain was identified as serogroup W-135 ST-11 by polymerase chain reaction and multilocus sequence typing. Approximately 1 month after treatment, she developed high fever, dyspnea, chest pain, and shoulder pain due to pericarditis, polyarthritis, and tenosynovitis, which are all relatively common immunoreactive complications of W-135 ST-11 meningococcal infections. This causative strain was the same as that responsible for an outbreak of meningitis among Hajj pilgrims in 2000. The strain is now found worldwide because it can attain a high carriage rate and has a long duration of carriage. We suspect that our patient's infection was acquired from an imported chronic carrier. Meningococcal meningitis is rare in Japan, with an incidence of only approximately 10-20 cases per year since the 1990s. Neisseria meningitidis serogroup W-135 is particularly rare in Japan (1), although it is commonly found in Africa, including the area known as thè`m eningitis belt.'' Serogroup W-135 sequence type (ST)-11 caused an outbreak of meningitis among Hajj pilgrims in Mecca in 2000 (2). To date, only one case of systemic W-135 meningococcal infection has been reported in Japan; however, it was not caused by type ST-11.A 44-year-old woman presented with fever (409 C), sore throat, left shoulder pain, chest pain, fatigue, and non-productive cough without meningeal irritation. She had not traveled to any foreign country. She was admitted to a hospital and was subsequently administered ceftriaxone. Her symptoms improved, and she was discharged on the 6th day of illness. N. meningitidis was isolated from her initial blood and sputum cultures. The minimum inhibitory concentrations of penicillin G and ceftriaxone against this strain were 0.025 and 0.002 mg/ml, respectively. On the 15th day of illness, she developed high fever and was admitted to another hospital. Her symptoms did not improve with oral antibiotic treatment, and she was referred to our hospital on the 21st day of illness. Subsequently, her symptoms almost completely resolved after treatment with nonsteroidal anti-inflammatory drugs and levofloxacin.On the 31st day of illness, the patient developed high fever and chest pain and was readmitted to our hospital. She had tenderness of the left shoulder and bilateral sternoclavicular joint pain, and she was unable to abduct her left arm because of pain. Laboratory testing showed an elevated leukocyte count of 13860 cells/ml and C-reactive protein level of 18.3 mg/dl. Electrocardiography showed low QRS voltage and negative T waves on leads V1 to V4. Chest X-ray and chest computed tomography (CT) showed pericardial and bilateral pleural effusions (Fig. 1A, B). 18 F-fluorodeoxy glucose (FDG) positron emission CT showed abnormal FDG uptake in the effusions, sh...

show abstract

“…The presence of palpable nodules, arthralgia and increased acute phase reactants lead to the diagnosis of vasculitis-athritis by immune complexes [4,5]. Although there are no protocols involving immunoglobulins for vasculitis management, it has been an effective and extensive treatment over the years in medical practice.…”

mentioning

confidence: 99%

Gammaglobulin Treatment in an Unusual Meningococcal Case

Garriga-Grimau

Laveglia

2013

Indian J Pediatr

View full text Add to dashboard Cite

Immune complex associated complications in the subacute phase of meningococcal disease: incidence and literature review

Cited by 60 publications

References 21 publications

Infection and immune-mediated meningococcal-associated arthritis: combination features in the same patient

Infection and immune-mediated meningococcal-associated arthritis: combination features in the same patient

Meningococcemia due to the 2000 Hajj-Associated Outbreak Strain (Serogroup W-135 ST-11) with Immunoreactive Complications

Gammaglobulin Treatment in an Unusual Meningococcal Case

Contact Info

Product

Resources

About