A Case of Primary Meningococcal Pericarditis Caused by Neisseria Meningitidis Serotype Y with Rapid Evolution into Cardiac Tamponade

Abstract

Primary meningococcal pericarditis (PMP) is a rare form of acute purulent pericarditis that often evolves into cardiac tamponade and usually requires pericardial drainage. PMP is a rare, difficult to diagnose, rapidly progressive form of meningococcal infections. PMP is typically caused by Neisseria meningitidis of serotype C, or, less commonly, B or W135. We report the second case of PMP caused by Neisseria meningitidis of serotype Y. Our patient was not critically ill at presentation, and her presentation could have been consistent with viral uncomplicated pericarditis with the exception of the mild leukocytosis with a left shift in the differential. Clinicians should be aware that early in the course of PMP, the illness may not be severe. Mild leukocytosis with a left shift or bandemia in the setting of what otherwise seems to be a case of uncomplicated viral pericarditis should prompt suspicion for PMP and further evaluation and/or monitoring.

Myopericarditis and atrial fibrillation complicating meningococcal meningitis in a human immunodeficiency virus-infected man who has sex with men: a case report

“…In addition, the incidence of meningococcal meningitis among men who have sex with men was reported to be 50-fold greater than the age-adjusted rate for the general population (Simon et al, 2013). Among the multiple complications associated with meningococcal meningitis, pericarditis and myocarditis have been recognized and reported since 1960 (Saslaw and Diserens, 1960;Wansbrough-Jones and Wong, 1973;Morgan et al, 2002; Z. Zhu and others Zeidan et al, 2008). The peculiarity of this care report lies in the cardiac involvement without evidence of bacteraemia, which made the pathophysiology less clear.…”

A Rare Case of Primary Meningococcal Myopericarditis in a 71-Year-Old Male

“…Like our patient, patients with PMP may not be severely ill on presentation [11]. This complicates differentiating PMP from viral pericarditis.…”

“…Contrary to other causes of purulent pericarditis, PMP has good prognosis when timely diagnosed and treated. All patients previously described in English literature have survived [6, 8, 11]. …”

Care of the Patient with Invasive Meningococcal Disease by Emergency Medical Service Clinicians: A Scoping Review Protocol

“…It carries a risk of death of between 20-50% (2). Rarely, meningococcal disease may present in other forms such as conjunctivitis (11) and pericarditis (12).…”