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Meningococcal Arthritis


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]
  • We report the first patient with both PMA and meningococcal endophthalmitis and present a review of the literature. An afebrile, non-toxic, 54-year-old female presented with arthritis and a painful red left eye following an episode of diarrhoea.[ncbi.nlm.nih.gov]
  • We present two pediatric cases of atypical presentation of meningococcal disease revealed by molecular tests. The clinical presentation of the two children (6- and 9-years-old) was characterized by signs of arthritis.[ncbi.nlm.nih.gov]
  • Comparisons of patient series from 1980 to the present with those reported before 1980 are described.[ncbi.nlm.nih.gov]
  • The clinical spectrum of meningococcal infection ranges from asymptomatic carriage to fulminant sepsis, with meningitis and septicemia being well-recognized clinical presentations.[ncbi.nlm.nih.gov]
Fever
  • The onset of arthritis showed a biphasic pattern with an early peak at 1-2 days and a later peak, heralded by typical recrudescence of fever, at 5-10 days which usually lasted 5-7 days.[ncbi.nlm.nih.gov]
  • 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]
  • A 67-year-old Caucasian man presented with acute-onset polyarthralgia, myalgia, and fever. On examination he had polyarticular synovitis.[ncbi.nlm.nih.gov]
  • […] 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]
Chills
  • 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]
  • 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]
  • Other signs and symptoms Acute fever and chills Headache Neck stiffness Low back and thigh pain Nausea and vomiting Confusion or unconsciousness Epileptic fits (seizures) Unstable vital signs, eg very low blood pressure, reduced blood flow, low urine[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
  • 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]
Pathologist
  • Kradin is also an Associate Pathologist at Massachusetts General Hospital in the Immunopathology Unit. His techniques include tissue culture and immunocytochemistry, flow cytometry, Northern blotting and immunocytochemistry. Dr.[books.google.de]
Chronic Fatigue Syndrome
  • Kradin has a number of clinical interests including Chronic Fatigue Syndrome, Interstitial Lung Disease, Multiple Chemical Sensitivity and Pulmonary Immunology. He also holds an Associate Professor position of Pathology at Harvard Medical School.[books.google.de]
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]
  • Other signs and symptoms Acute fever and chills Headache Neck stiffness Low back and thigh pain Nausea and vomiting Confusion or unconsciousness Epileptic fits (seizures) Unstable vital signs, eg very low blood pressure, reduced blood flow, low urine[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]
Cutaneous Manifestation
  • Although arthritis occurs in the setting of meningococcal meningitis, it may also be seen as a primary event without neurological involvement and with or without cutaneous manifestations.[ncbi.nlm.nih.gov]
Arthritis
  • This should be considered in the differential diagnosis of reactive arthritis and acute dermatitis-arthritis syndrome.[ncbi.nlm.nih.gov]
  • Meningococcal arthritis is rare. We report a patient in whom a first episode of meningococcal arthritis revealed Waldenström's disease and who experienced a second episode of meningococcal arthritis 8 years later.[ncbi.nlm.nih.gov]
  • Primary meningococcal arthritis (PMA) is, on the other hand, a rare form of meningococcal disease presenting as an isolated septic arthritis without other signs of meningococcal disease.[ncbi.nlm.nih.gov]
  • A 38-year-old African-American male complaining of pain in multiple joints was initially diagnosed with gouty arthritis concurrent with gonococcal septic arthritis.[ncbi.nlm.nih.gov]
  • Among the different types of arthritis associated with meningococcal disease, isolated primary meningococcal arthritis is unusual.[ncbi.nlm.nih.gov]
Headache
  • 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]
  • 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]
  • 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]
  • After effects most likely to be caused by meningitis Memory loss/lack of concentration/difficulty retaining information Clumsiness/co-ordination problems Headaches Deafness/hearing problems/tinnitus/dizziness/loss of balance Epilepsy/seizures Weakness[meningitis.org]

Treatment

  • After specific antimicrobial treatment, the clinical conditions of the two patients quickly improved during hospitalization.[ncbi.nlm.nih.gov]
  • Successful treatment was achieved by the intravenous administration of penicillin G.[ncbi.nlm.nih.gov]
  • After surgical drainage the prosthesis was retained and the patient received appropriate and prolonged antibiotic treatment. The outcome was favourable, as with primary meningococcal arthritis affecting native joints.[ncbi.nlm.nih.gov]
  • Primary meningococcal arthritis (PMA) is a relatively rare diagnosis where the role of early surgical intervention for its treatment is not well defined.[ncbi.nlm.nih.gov]
  • Primary meningococcal arthritis (PMA) and endophthalmitis are important diagnoses to recognise as delayed treatment would result in permanent joint and eye damage.[ncbi.nlm.nih.gov]

Prognosis

  • If properly treated the prognosis is good.[ncbi.nlm.nih.gov]
  • […] 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]
  • Prognosis Mortality is now 2-11%. It is highest (10%) in neonates.[patient.info]

Epidemiology

  • In addition, background information on epidemiology, pathogenesis and pathophysiology encourages a fuller understanding of conditions, and over 250 full colour images help with diagnosis when treating patients.[books.google.de]
  • The changing epidemiology of meningococcal disease in the United States, 1992–1996. J Infect Dis. 1999; 180 :1894–1901. [ PubMed ] [ Google Scholar ] 2. Bookstaver PB, Rudisill CN.[ncbi.nlm.nih.gov]
  • 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]
  • 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]
Sex distribution
Age distribution

Pathophysiology

  • Bacteremia is a key step in the pathophysiology of meningococcal disease and precedes any form of invasive infection.[ncbi.nlm.nih.gov]
  • In addition, background information on epidemiology, pathogenesis and pathophysiology encourages a fuller understanding of conditions, and over 250 full colour images help with diagnosis when treating patients.[books.google.de]
  • (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]

Prevention

  • This up-to-date and essential reference tool, supports all medical professionals in the treatment and prevention of infectious diseases.[books.google.de]
  • 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]
  • A vaccine can prevent meningococcal infections. Meningococcemia (Medical Encyclopedia) Waterhouse-Friderichsen syndrome (Medical Encyclopedia) [ Read More ][icdlist.com]
  • 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]

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