Chronic meningococcemia

The spectrum of Neisseria meningitidis-associated clinical entities involves mild forms of disease, without neurological involvement or sepsis, and asymptomatic carrier states. Rarely, N. meningitidis bacteremia can be associated with a prolonged fever with or without arthritis, which we designate as chronic meningococcemia. Chronic meningococcemia is an uncommon entity, usually associated to serogroup B N. meningitidis. Diagnosis is frequently delayed as blood cultures collected outside febrile periods can be negative. We present a case of chronic meningococcemia in a 22-year-old woman with no relevant clinical background, presenting with fever, arthralgia and exanthem. Due to the potential for progression to more severe disease and the risk of N. meningitidis transmission and development of secondary cases, a high degree of clinical suspicion is required to ensure prompt recognition and adequate treatment. Our patient had a favorable outcome probably due to early recognition and adequate treatment, which is critical for the resolution of the disease without complications.

Chronic meningococcemia in a vertically HIV-infected adolescent

• Chronic meningococcemia is a rare manifestation of meningococcal disease.

• Few cases of this presentation both in previously healthy and immunocompromised patients, such HIV patients.

• The association between Neisseria meningitidis infection and HIV infection is not yet well defined.

Chronic meningococcemia is a rare manifestation of meningococcal disease, characterized by a period of more than one week of intermittent or continuous fever, arthralgia and skin lesions without meningitis. It can occur both in previously healthy and immunocompromised patients. The gold standard for the diagnosis is culture isolation of Neisseria meningitidis in sterile material. We describe a case of a vertically HIV-infected adolescent with chronic meningococcal disease.

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

Chronic meningococcemia is an uncommon disorder, representing a diagnostic challenge. Classically, this pathology would be considered in young adults with a history of episodes of fever, disseminated cutaneous vasculitis and arthralgia. Exact and rapid diagnosis is often further challenged by the fact that routine microbiological investigations frequently failed to identify incriminated micro-organism, Neisseria meningitidis. Here we present the case of a young man not presenting with the classical triad.