Primary Meningococcal Type C Arthritis: A Case Report and Literature Review

Abstract

Acute septic arthritis is a common clinical problem in emergency departments. Primary meningococcal arthritis (PMA) is very rare and few cases are reported in literature. D. B. M. consulted the emergency department for knee pain and fever; analysis showed that the cause was a Neisseria meningitidis type C infection. He received a treatment consisting of 2 arthroscopies and 5 weeks of antibiotics. At five weeks he returned to work and at 2 months he resumed sports (jogging and soccer) without complaints. Primary arthritis of the knee caused by Neisseria meningitidis is very rare. It has a very good response to antibiotics and arthroscopy procedure. Short-term follow-up and functional results are often good or excellent.

Primary meningococcal arthritis in a COVID-19 18-year-old man: a case report and review of the literature

“…Worldwide, 10% of human beings are considered asymptomatic carriers of Neisseria meningitidis [ 1 ]. It can be a potentially aggressive bacteria, causing invasive and possibly deadly infections such as meningitis or septicemia [ 1 , 2 ]. Indeed it is known to cause fever, headache, nausea, vomiting, severe myalgias, nonspecific rash, sore throat and upper respiratory symptoms.…”

“…Nonetheless some similarities can be found in the reported cases, such as age, medical history, and clinical presentation. Young people, male or female [ 6 ] with no medical history are most represented [ 2 – 4 ], but we can also find several cases over the age of 60 [ 3 , 7 ]. The knee is very often involved, either as monoarthritis or as part of an oligoarthritis.…”

“…These infections are accompanied with morbidity, limited functional use of the impaired joints and reduced quality of life. Nowadays, it is acknowledged that a quick treatment, including surgical joint drainage and initial intravenous antibiotherapy reduces such consequences [ 2 ]. Up to 2019, only 47 cases of PMA have been reported in PubMed [ 3 ].…”

Treatment of <i>Neisseria meningitidis</i> prosthetic joint infections with short-course antibiotics: three cases and a literature review

“…Neisseria meningitidis is a Gram-negative, aerobic, oxidasepositive diplococcus, for which humans are the only natural host. The organism is best known as a cause of purpura fulminans with bacteraemia and meningitis; however, urogenital infections, pneumonia, chronic bacteraemia, and native joint infections also occur (Murray et al, 2016;Barahona et al, 2017). Whilst virulent, N. meningitidis is typically very sensitive to beta-lactam antibiotics and fluoroquinolones, with successful outcomes using short courses of antimicrobials in the absence of surgical intervention reported in native joint septic arthritis (Cabellos et al, 2012).…”

“…To our knowledge, there are only three previously reported cases of meningococcal prosthetic joint infection (Vikram et al, 2001;Becerril Carral et al, 2017;Mc Carthy et al, 2020). These cases were managed with at least 12 weeks of antimicrobial therapy, commencing with an intravenous beta-lactam followed by oral ciprofloxacin or amoxicillin (Table 1).…”