The Role of Particular Strains of Neisseria meningitidis in Meningococcal Arthritis, Pericarditis, and Pneumonia

Vienne, Pascale; Ducos-Galand, Magaly; Guiyoule, Annie; Pirès, René; Giorgini, Dario; Taha, Muhamed‐Kheir; Alonso, Jean-Michel

doi:10.1086/379719

Cited by 104 publications

(69 citation statements)

References 19 publications

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“…However, beginning in 2010, several countries have reported an increase in IMD due to ST-11 MenW (19)(20)(21)(22). Unusual clinical presentation of MenW IMD due to this clone has been reported and the possibility of endemic local transmission has also been suggested (23,24). The finding of six MenW cases associated with the ST-11 cc in Ontario since May 2014 was unusual, especially as none have reported any travel to the Hajj or exposure to individuals returning from the Hajj.…”

Section: Discussionmentioning

confidence: 98%

Invasive serogroup W Neisseria meningitidis (MenW) in Ontario, Canada shows potential clonal replacement during the period January 1, 2009 – June 30, 2016

et al. 2016

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Section: Discussionmentioning

confidence: 98%

Invasive serogroup W Neisseria meningitidis (MenW) in Ontario, Canada shows potential clonal replacement during the period January 1, 2009 – June 30, 2016

et al. 2016

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“…Se trató de una mujer de 57 años con una epiglotitis aguda, un joven de 17 años con una neumonía condensante y un hombre adulto mayor de 91 años con Estudios previos han descrito asociaciones de los diferentes serogrupos con presentaciones más septicémicas y con menor compromiso menín-geo 6 . Series clínicas han señalado que las manifestaciones de la EMI por serogrupo W podrían tener algunas diferencias respecto de las provocadas por los serogrupos B y C, con menos invasión al SNC y mayor frecuencia de manifestaciones extra-meníngeas asociadas a la meningococcemia 7 . Asimismo, las infecciones respiratorias también han sido reportadas para los serogrupos W e Y como una presentación clínica de mayor frecuencia a diferencia de otros serogrupos 8 .…”

Section: A Vigilancia De Enfermedad Meningocóccica Invasora (Emi) Enunclassified

Infecciones respiratorias bacteriémicas por Neisseria meningitidis serogrupo W

Rosas

Durán

et al. 2015

Rev. chil. infectol.

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Respiratory infections and bacteremia caused byNeisseria meningitidis serogroup W 2 , luego de haberse descrito en Europa, el año 2000, un aumento de los casos de EMI en relación a la peregrinación al "Hajj" en Arabia Saudita 3 . En los meses siguientes a la festividad musulmana ese año, se reportaron más de 400 casos en 16 países, demostrándose con posterioridad la clonalidad genética de una cepa hipervirulenta 4 . El serogrupo W se ha asociado en el mundo a prevalencias entre 1 y 8% del total de casos de EMI, con tasas bajas de portación. No obstante, la emergencia de clones hipervirulentos ha demostrado su capacidad para diseminarse y producir brotes epidémicos secundarios, afectando en Chile con mayores tasas de ataque y mayor letalidad a grupos etarios extremos 5 . Considerando la emergencia de este nuevo patógeno en Chile, nos parece relevante comunicar la experiencia reciente de tres pacientes adultos hospitalizados durante el 2013 en Clínica Alemana de Santiago. Los pacientes cursaron con meningococcemia por N. meningitidis serogrupo W y presentaron una infección respiratoria primaria seguida de rápido deterioro clínico, asociado a una intensa respuesta inflamatoria sistémica. Se trató de una mujer de 57 años con una epiglotitis aguda, un joven de 17 años con una neumonía condensante y un hombre adulto mayor de 91 años con Estudios previos han descrito asociaciones de los diferentes serogrupos con presentaciones más septicémicas y con menor compromiso menín-geo 6 . Series clínicas han señalado que las manifestaciones de la EMI por serogrupo W podrían tener algunas diferencias respecto de las provocadas por los serogrupos B y C, con menos invasión al SNC y mayor frecuencia de manifestaciones extra-meníngeas asociadas a la meningococcemia 7 . Asimismo, las infecciones respiratorias también han sido reportadas para los serogrupos W e Y como una presentación clínica de mayor frecuencia a diferencia de otros serogrupos 8 . No obstante, se plantea que el compromiso respiratorio podría verse favorecido por otra infección del tracto respiratorio que provoque las condiciones locales para una invasión de cepas de N. meningitidis colonizantes de la vía aérea 9 . Si este cambio de la epidemiología está afectando actualmente el espectro de manifestaciones clínicas de la EMI en Chile, es desconocido. Sin embargo, se hace necesario dilucidar esta interrogante con la perspectiva de mejorar el diagnóstico precoz en un escenario de incremento de la endemia, secundario a la introducción de un serogrupo emergente. La observación clínica de presentaciones atípicas en Chile donde el predominio del serogrupo W está impactando con una mayor letalidad a grupos etarios extremos (lactantes menores y adultos mayores), debe ser difundida. En este contexto, parece razonable considerar a la EMI dentro del diagnóstico diferencial de las sepsis severas de foco respiratorio.

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“…Serotype Y was more likely to be found in immunosuppressed patients. 20 The clinical implications of serotyping may not be obviously apparent, but the introduction of the meningococcal conjugate vaccine may play an important role in the future of the disease. The vaccine is recommended for children 11 to 12 years old, unvaccinated adolescents entering high school, and previously unvaccinated college freshmen.…”

Section: -11mentioning

confidence: 99%

Primary Meningococcal Arthritis

Harwood

Womack

Kapur

2008

The Journal of the American Board of Family Medicine

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Meningitis and the clinical syndrome of acute meningococcemia are well-described sequelae from infections caused by Neisseria meningitidis. Within the realm of this syndrome, secondary sites of infection are not uncommon. There is a concomitant septic arthritis in 11% of cases of meningococcemia. 1 We describe below the rare clinical scenario of a 29-year-old woman with primary meningococcal arthritis without the clinical syndrome associated with meningococcemia. Case ReportA 29-year-old woman presented to the outpatient office with a chief complaint of an acutely painful and swollen left knee. On awaking that morning, she noted a decreased ability to flex and extend her left knee and extreme pain during ambulation. She had no medical or surgical history and was not on any medications. When doctors inquired about sexual contacts, she stated she had not been sexually active in the past 3 months. Three weeks before, she had a negative screening test for Neisseria gonorrhea and Chlamydia trachomatis during an annual gynecologic examination. She was afebrile and other vital signs were normal. She appeared to be well, but an erythematous, warm, swollen left knee that was diffusely tender to palpation was found. Active and passive range of motion was severely limited secondary to pain. An erythematous, macular rash was noted on the bilateral lower extremities. She was promptly transferred to the hospital with the diagnosis of septic arthritis.Orthopedic surgery consultation was obtained on arrival to the emergency department. Aspiration of the left knee yielded grossly purulent synovial fluid. It was sent for evaluation by Gram stain, culture, cell count, and crystal analysis. Serum laboratory testing for C-reactive protein, complete blood cell count, and 2 sets of blood cultures was performed (see Table 1). The patient was started on Vancomycin 1 g intravenously every 12 hours for Gram-positive bacteria, given the initial gram stain result. She was taken to the operating room for urgent arthroscopic incision, drainage, and lavage of the left knee. During transportation to the operating room, the patient developed pain in the left shoulder. Examination at that time revealed decreased range of motion secondary to pain. Arthrocentesis of the left shoulder, while the patient was under anesthesia, yielded grossly purulent fluid. Open incision and drainage of the left shoulder was performed, followed by arthroscopic incision and drainage of the left knee.On postoperative day 1, blood cultures and synovial fluid cultures collected from operative intervention revealed Gram-negative diplococci. Ceftriaxone 1 g intravenously every 24 hours was initiated for presumed gonococcal arthritis. Soon thereafter, the organisms were identified as Neisseria meningitides; vancomycin was discontinued. Two sets of blood cultures revealed N. meningitidis. The patient had fever of 102.9°F on postoperative day 2, but she remained stable and never showed signs or symptoms of meningitis or the clinical syndrome of meningococcemia during her hosp...

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The Role of Particular Strains of Neisseria meningitidis in Meningococcal Arthritis, Pericarditis, and Pneumonia

Cited by 104 publications

References 19 publications

Invasive serogroup W Neisseria meningitidis (MenW) in Ontario, Canada shows potential clonal replacement during the period January 1, 2009 – June 30, 2016

Invasive serogroup W Neisseria meningitidis (MenW) in Ontario, Canada shows potential clonal replacement during the period January 1, 2009 – June 30, 2016

Infecciones respiratorias bacteriémicas por Neisseria meningitidis serogrupo W

Primary Meningococcal Arthritis

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