Value of a Novel Neisseria Meningitidis–Specific Polymerase Chain Reaction Assay in Skin Biopsy Specimens as a Diagnostic Tool in Chronic Meningococcemia

Parmentier, Laurent; Garzoni, Christian; Antille, Christophe; Kaiser, Laurent; Ninet, Béatrice Alice Bescher; Borradori, Luca

doi:10.1001/archderm.144.6.770

Cited by 29 publications

(16 citation statements)

References 38 publications

(16 reference statements)

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“…Microbiological research by PCR has the advantage of maintaining good sensitivity despite the introduction of antibacterial therapy and can be performed on different many samples [8,9]. In the case of our patient, bacteriological analyses involved several clinical samples including CSF, pharynx and skin biopsies [8,9]. As mentioned before, PCR confirmed secondary meningeal involvement.…”

Section: Discussionsupporting

confidence: 60%

“…The PCR technique has been therefore proved highly precious to confirm diagnosis and rapid treatment implementation. Microbiological research by PCR has the advantage of maintaining good sensitivity despite the introduction of antibacterial therapy and can be performed on different many samples [8,9]. In the case of our patient, bacteriological analyses involved several clinical samples including CSF, pharynx and skin biopsies [8,9].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Chronic meningococcemia presenting with recurrent painful rash and poly-arthralgia without fever

Delwaide¹,

Leeuw²,

Audigier³

et al. 2018

IDCases

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Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Chronic meningococcemia presenting with recurrent painful rash and poly-arthralgia without fever

Delwaide¹,

Leeuw²,

Audigier³

et al. 2018

IDCases

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“…Clinical manifestations of meningococcemia, including the acute onset of fever, hypotension, DIC, multiple organ failure, and in severe cases, osteonecrosis due to DIC, reflect the systemic symptoms of the infection (43). Petechial, purpuric, or maculopapular rash and arthritis are also reported as systemic signs (31,44,45). While these skin rashes are often observed all over the body, including in the mucous membranes, they occur predominantly on the extremities (11).…”

Section: Clinical Manifestationsmentioning

confidence: 99%

“…The sensitivity of a PCR is higher than the sensitivities of CSF or blood culture analyses (56). In addition, the PCR of skin biopsy cultures (100%) has been shown to be more sensitive than the PCR of blood cultures (58.8%) (44,57). These findings indicate that although PCR assays are very effective in diagnosing meningococcemia, bacterial culture is still necessary for the testing of antibiotic susceptibility.…”

Section: Diagnosismentioning

confidence: 99%

Meningococcemia in Adults: A Review of the Literature

Takada

Fujiwara

Inoue³

et al. 2016

Intern. Med.

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We mainly refer to the acute setting of meningococcemia. Meningococcemia is an infection caused by Neisseria meningitidis, which has 13 clinically significant serogroups that are distinguishable by the structure of their capsular polysaccharides. N. meningitidis, also called meningococcus, is a Gram-negative, aerobic, diplococcus bacterium. The various consequences of severe meningococcal sepsis include hypotension, disseminated intravascular coagulation (DIC), multiple organ failure, and osteonecrosis due to DIC. The gold standard for the identification of meningococcal infection is the bacteriologic isolation of N. meningitidis from body fluids such as blood, cerebrospinal fluid (CSF), synovial fluid, and pleural fluid. Blood, CSF, and skin biopsy cultures are used for diagnosis. Meningococcal infection is a medical emergency that requires antibiotic therapy and intensive supportive care. Management of the systemic circulation, respiration, and intracranial pressure is vital for improving the prognosis, which has dramatically improved since the wide availability of antibiotics. This review of the literature provides an overview of current concepts on meningococcemia due to N. meningitidis infection.

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“…With the rash present in greater than 90% of cases, some case reports have recently described the diagnostic value of polymerase chain reaction on skin biopsy specimens. 9 The prognosis of CM varies significantly. When not recognized or treated, CM can progress to meningitis or acute meningococcemia.…”

Section: Discussionmentioning

confidence: 99%