Acute meningococcemia in childhood. Case report and review

Abstract

Acute meningococcemia is a disseminated infection caused by Neisseria meningitidis, a gram-negative diplococcus, with high mortality rates in those with fulminant disease. The disease is acquired through asymptomatic carrier(s) due to nasopharyngeal colonization or invasive disease. It affects only humans. The clinical septicaemic features can present themselves either with or without meningitis and it is considered an invasive meningococcal disease. Fever and skin involvement such as purpuric rash can be the most dramatic aspect of the disease and is often the first sign that leads to the clinical consideration of meningococcemia. Early recognition is critical to implement prompt antibiotic therapy and supportive care. We report a case of acute meningococcemia without meningitis of a four-year-old male child with clinical history of one week onset of upper respiratory infection that progressed to lower respiratory infection accompanied by fever and purpuric rash. The cerebrospinal fluid analysis revealed bacteria, gram negative diplococci suggestive of Neisseria meningitidis infection. He received prompt antibiotic therapy and fluid resuscitation, reflected in the survival of this patient with no apparent sequelae.