Aspects cliniques et évolutifs des infections à méningocoque W135 chez l'enfant : à propos de cinq observations

Epidemiology and Clinical Burden of Meningococcal Disease in France: Scoping Review

Invasive meningococcal disease (IMD) remains a significant health concern due to its unpredictable nature and its rapid progression. Even if occurrence of IMD is strictly monitored by a national surveillance network, no information on long-term sequelae is reported, making it difficult to assess the entire clinical burden of IMD in France. The aim of this scoping review was to analyze the epidemiology and the clinical burden of IMD in France by reporting the main epidemiological parameters, and by describing the clinical consequences and the care pathway of patients. The process of the review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension to the Scoping Reviews guidelines. In France, the incidence of IMD cases has been fluctuating over time, characterized by an overall downward trend linked to a decrease in Sg B cases and the introduction of mandatory vaccination against Sg C. Sg W cases increased in recent years (from 5% to 21% in 2019). The case fatality rate remained constant (6-12.9%). The most frequently reported sequelae were severe neurological disorder, epilepsy, and anxiety. However, data on sequelae and care pathways were scarce. Further research should concentrate on providing robust identification of sequelae and the subsequent impact on quality of life, as well as on the organization of optimal care and support for patients and their families.

Endogenous Meningococcal Endophthalmitis with Isolated Joint Involvement in Immunocompetent Adults

PURPOSE

We report two cases of endogenous meningococcal endophthalmitis in immunocompetent adults presenting with unilateral ocular disease and joint involvement.

METHODS

A retrospective review of two patients with endogenous endophthalmitis due to Neisseria meningitidis with associated arthropathy was conducted. The clinical presentation, investigations, treatment, and outcomes are presented.

RESULTS

Vitreous sampling confirmed Neisseria meningitidis via polymerase chain reaction (PCR) in both cases. PCR was positive from the knee aspirate of our second case. Both patients received topical steroids and topical, intravitreal and intravenous antibiotics. Despite this, visual outcomes were poor.

CONCLUSIONS

This atypical combination of endogenous meningococcal endophthalmitis associated with meningococcal joint involvement could represent a novel pattern for the presentation of metastatic meningococcal endophthalmitis not previously described. We suggest joint aspirate PCR could be a useful adjunctive test to identify potential causative organisms in such cases where there is concurrent joint involvement in the absence of systemic features.