Presentation
The earlier described entity of primary meningococcal arthritis (PMA) can present in patients with meningococcal bacteraemia, and may not be distinct from disseminated meningococcal disease, but rather an atypical presentation of this. [ncbi.nlm.nih.gov]
Background: Neisseria meningitidis infections most commonly present with meningitis (50%); arthritis is uncommon and only present in 2–8% of cases. [rheumatology.oxfordjournals.org]
Entire Body System
- Fever
The child continued to have low grade fever to 101 F (rectally), but was well clinically. On day 11 of hospitalization, the child developed fever to 102 F and was noted to have a warm swollen left knee. [healio.com]
[…] continued 113 POLYMYALGIA RHEUMATICA 114 POLYMYOSITIS and DERMATOMYOSITIS 115 PONDEROUS PURSE DISEASE 116 PSORIATIC ARTHROPATHY 117 PSYCHOGENIC RHEUMATISM 118 PUSTULOTIC ARTHROOSTEITIS 119 PYODERMA GANGRENOSUM 120 PYROPHOSPHATE ARTHROPATHY 121 RATBITE FEVER [books.google.de]
He completed a 4 week course of ceftriaxone with normalization of fevers and CRP and his joints subsequently settled with no residual damage. [rheumatology.oxfordjournals.org]
Paratyphoid fever A A01.2 Paratyphoid fever B A01.3 Paratyphoid fever C A01.4 Paratyphoid fever, unspecified A02 Other salmonella infections A02.0 Salmonella enteritis A02.1 Salmonella septicaemia A02.2 Localized Salmonella infections A02.8 Other specified [www0.sun.ac.za]
Primary meningococcal arthritis is a rare infectious disease that occurs in less than 3% of meningococcal infections and is characterized by arthritis without meningitis, fever, rash, or hemodynamic instability Barahona [Case Rep Orthop 4696014:2017 ] [ncbi.nlm.nih.gov]
- Chills
Results: This gentleman with background of type 2 diabetes mellitus and asthma was admitted with 3 day history of fevers and chills followed by non-bloody diarrhoea and developed polyarthritis 24 hours into this episode. [rheumatology.oxfordjournals.org]
Symptoms of infectious arthritis include Intense pain in the joint Joint redness and swelling Chills and fever Inability to move the area with the infected joint One type of infectious arthritis is reactive arthritis. [icdlist.com]
Signs and symptoms of meningococcal disease Meningococcal meningitis Meningococcemia Children >1 year and adults Neck stiffness Headache Nausea and vomiting Neck and/or back pain Fever and chills Increased sensitivity to light Irritability, confusion [dermnetnz.org]
Symptoms The most common symptoms of meningococcal meningitis are: Fever Chills Headache Vomiting Stiff neck Rash Confusion Symptoms may also include: Seizures Coma Inability to completely extend the legs Stiffness in knees and hips Shock The symptoms [healthcentral.com]
The most common clinical findings associated with invasive meningococcal infection are fever, chills, malaise and rash. The rash begins as macules, maculopapules, or urticaria, but petechiae and purpura develop rapidly. [clinicaladvisor.com]
- Rigor
There was no history of diarrhoea, vomiting, headache, chills and rigors. He did not have any seizures, altered sensorium, and any history of trauma or upper respiratory tract infection prior to this. [ijmm.org]
Case report An 18-year-old man presented with a 36 h history of headache, rigors, and malaise. There were signs of meningism and a widespread petechial rash. There was no focal neurological deficit. [nature.com]
Gastrointestinal
- Nausea
Meningococcal meningitis typically starts like the flu, with the sudden onset of an intense headache, fever, sore throat, nausea, vomiting, and malaise. [medicinenet.com]
Signs and symptoms of meningococcal disease Meningococcal meningitis Meningococcemia Children >1 year and adults Neck stiffness Headache Nausea and vomiting Neck and/or back pain Fever and chills Increased sensitivity to light Irritability, confusion [dermnetnz.org]
Meningococcal disease is characterized by sudden onset of fever, intense headache, nausea and often vomiting, stiff neck, and a rash that initially may be urticarial, maculopapular, petechial, or, very rarely, vesicular. [moh.gov.sg]
Symptoms in babies and young children Symptoms of meningococcal disease in infants and young children can include: fever refusing to feed irritability, fretfulness grunting or moaning extreme tiredness or floppiness dislike of being handled nausea or [betterhealth.vic.gov.au]
The symptoms include sudden onset of fever, intense headache, nausea and often vomiting, stiff neck and frequently a rash. The symptoms may appear 1 to 10 days after exposure, but commonly less than 4 days after exposure. [web.ccsu.edu]
Musculoskeletal
- Arthritis
This should be considered in the differential diagnosis of reactive arthritis and acute dermatitis-arthritis syndrome. [ncbi.nlm.nih.gov]
- Joint Effusion
The other variety of gonococcal arthritis typically is monoarticular, with a large culturally positive joint effusion. [healio.com]
Joint effusions usually resolve without a change in therapy; occasionally, repeated arthrocentesis is needed to control symptoms. [emedicine.medscape.com]
Neurologic
- Headache
Symptoms begin mildly – like a cold or flu with fever, headache, aches and pains in joints and muscles. They progress rapidly into much more severe effects. [meningitis.ca]
He denied any headache, neck stiffness, rash or back pain. He was pyrexial and had symmetrical inflammation in PIPJ, MCPJ, wrists, elbows, shoulders, knees, ankles and feet. General examination was unremarkable. [rheumatology.oxfordjournals.org]
Meningococcal meningitis typically starts like the flu, with the sudden onset of an intense headache, fever, sore throat, nausea, vomiting, and malaise. [medicinenet.com]
Meningitis is marked by many cold and flu-like symptoms, such as a headache and a high fever. Its symptoms also include confusion, or irritability in infants, and a stiff neck. [healthline.com]
However, anyone who becomes ill with mild flu like symptoms should watch for the sudden onset of increased fever (101 or greater) with headache, vomiting, rash or change in mental state. [web.ccsu.edu]
Treatment
After specific antimicrobial treatment, the clinical conditions of the two patients quickly improved during hospitalization. [ncbi.nlm.nih.gov]
Treatment includes medicines and sometimes surgery. [icdlist.com]
Prognosis
If properly treated the prognosis is good. [ncbi.nlm.nih.gov]
The prognosis is excellent and joint complications are rare once rapid diagnosis and treatment is given. ~ Conclusion It is an emergency condition that needs early diagnosis and treatment as the prognosis is good in such cases. [ijmm.org]
[…] young people younger than 16 years in primary and secondary care Links: epidemiology risk factors for invasive meningococcal disease clinical features investigations management of bacterial meningitis complications prophylaxis poor prognostic indicators prognosis [gpnotebook.co.uk]
With prompt treatment, the prognosis is excellent. [en.wikipedia.org]
[…] that some cases likely represent merely an allergic phenomenon and not a direct innoculation of the organism into the synovium.33-35 Although historically the arthritis has been considered a rather benign accompaniment and bearing a routinely excellent prognosis [healio.com]
Etiology
Nelson J: Bacterial etiology and antibiotic management of septic arthritis in infants and children. Pediatrics 50(3):437, 1972. 11. Gillespie R: Septic arthritis of childhood. Clin Orthop 96:152, 1973. 12. [healio.com]
With the implementation of vaccination programs, the etiology has shifted and new serogroups have emerged as important causes of MD. Currently serogroups B and C are responsible for the majority of cases of MD worldwide. [omicsonline.org]
Empiric therapy Empiric antibiotic therapy ensures coverage of likely meningeal pathogens when no rash is present, when the etiology of meningitis is uncertain, and when an immediate microbiologic diagnosis is unavailable. [emedicine.medscape.com]
Epidemiology
Objectives After completing this article, readers should be able to: Understand the epidemiology of Neisseria meningitidis infections. Understand which patients are at increased risk of invasive and recurrent meningococcal disease. [pedsinreview.aappublications.org]
Harrison LH (2010) Epidemiological profile of meningococcal disease in the United States. Clin Infect Dis 50 Suppl 2: S37-44. [omicsonline.org]
The changing and dynamic epidemiology of meningococcal disease. Vaccine 2012 ; 30 : B26 – 36. 11. Centers for Disease Control and Prevention. [cambridge.org]
Epidemiology and Prevention of Vaccine-Preventable Diseases. Meningococcal disease. Atkinson, W., Wolfe, S., Hamborsky, J. McIntyre, L. eds. 13th ed. Washington DC: Public Health Foundation, 2015 (493 KB). Accessed 01/25/2018. CDC. [historyofvaccines.org]
Bacterial meningitis and meningococcal septicaemia Management of bacterial meningitis and meningococcal septicaemia in children and young people younger than 16 years in primary and secondary care Links: epidemiology risk factors for invasive meningococcal [gpnotebook.co.uk]
Pathophysiology
Bacteremia is a key step in the pathophysiology of meningococcal disease and precedes any form of invasive infection. [ncbi.nlm.nih.gov]
(This is a very comprehensive chapter which reviews pathophysiology as well as clinical presentation and management of this infection in infants and children.) Rosenstein, N, Perkins, B, Stevens, D. [clinicaladvisor.com]
Pathophysiology of meningococcal meningitis and septicaemia. Arch Dis Child. 2003 Jul. 88(7):601-7. [Medline]. [Full Text]. Faust SN, Levin M, Harrison OB, Goldin RD, Lockhart MS, Kondaveeti S, et al. [emedicine.medscape.com]
"Pathophysiology, treatment and outcome of meningococcemia: a review and recent experience". Pediatr. Infect. Dis. J. 15 (11): 967–78, quiz 979. doi : 10.1097/00006454-199611000-00009. PMID 8933544. ^ a b Ross SC, Densen P; Densen (September 1984). [en.wikipedia.org]
Pathan N, Faust SN, Levin M (2003) Pathophysiology of meningococcal meningitis and septicaemia. Arch Dis Child 88: 601-607. [omicsonline.org]
Prevention
Top experts have created state-of-the-art clinical reviews devoted to the following topics: Native septic arthritis; Reactive arthritis; Prevention of infection in orthopedic prosthetic surgery; Infections of the spine; Radiologic approach to musculoskeletal [books.google.de]
Sources Centers for Disease Control and Prevention. Epidemiology and Prevention of Vaccine-Preventable Diseases. Meningococcal disease. Atkinson, W., Wolfe, S., Hamborsky, J. McIntyre, L. eds. 13th ed. [historyofvaccines.org]
In this article, we review the basic microbiology, epidemiology, clinical presentation, treatment, and prevention of meningococcal disease. Microbiology N meningitidis is an aerobic, nonmotile Gram-negative diplococcus bacterium. [pedsinreview.aappublications.org]
Epidemiology and Prevention of Vaccine-Preventable Diseases (12th ed.). Washington DC: Public Health Foundation. pp. 193–204. Archived from the original on 10 March 2017. [en.wikipedia.org]
Casual contact (in a classroom or office) is not usually significant to warrant preventive medication. How effective is the vaccine to prevent the disease? The meningococcal vaccine (MCV4) has been shown to be safe and effective. [web.ccsu.edu]