Allergic Complications of Meningococcal Disease II--Immunological Investigations

Abstract

Circulating antibody was detectable in three of the four patients about a week after the onset of the illness. A marked fall in the serum C. level occurred in two patients at about that time. Deposits of meningococcal antigen, immunoglobulin, and C, were detected in the synovial fluid white cells of the two patients studied and in one of three skin biopsies examined. These findings suggest that the arthritis and cutaneous lesions of meningococcal meningitis may be due to immune complex formation.

A new classification for pericarditis associated with meningococcal infection

“…The pathogenesis of RMP may be similar, particularly since hypersensitivity reactions are more frequent with serogroup C N. meningitidis infections [12,20,34,36]. Morse et al [36] described 6 of 32 patients with meningococcal meningitidis who had pericarditis following group C N. meningitidis infection despite adequate antibiotic treatment.…”

Arthritis in Children With Bacterial Meningitis

“…Joint-fluid aspirations were done in 44 patients; 22 cases (50%) had bacteria or bacterial antigen identified In joint fluid by culture, Gram's stain, or counter\x=req-\ immunoelectrophoresis: H Influenzae (20 cases), N meningitidis (one case), and S aureus (one case). Of the 48 patients, 14 patients were noted to have arthritis at the time of diagnosis of meningitis, 16 patients on the first to sixth day, and 17 patients on the seventh day of treatment or later; one patient developed arthritis 12 days after treatment of H influenzae meningitis had been stopped. Fourteen cases with a culture\x=req-\ proved bacterial etiology of the arthritis developed arthritis within four days of treatment; the exception was a patient who developed arthritis after treatment of meningitis was stopped.…”

“…were noted to have arthritis at the time of diagnosis of meningitis,16 patients on the first to sixth day, and 17 patients on the seventh day of treatment or later; one patient developed arthritis 12 days after treatment of H influ¬ enzae meningitis had been stopped(Fig 1). All cases with proved bacterial etiology of the arthritis by culture developed arthritis within four days of treatment except for the child who…”

Meningococcal septicemia presenting as bilateral endophthalmitis

“…Some observers believe that chronic meningococcemia is a hypersensitive state in which many of the clinical manifestations are allergic in nature. 7 Our case was unique because bilateral blurring of vision was the initial presentation of meningococcemia. In other reported cases of meningococcal sepsis with endophthalmitis, 2,8 septic embolization is the suggested route of infection, with findings compatible with those of an allergy.…”