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Neisseria Meningitidis


Presentation

  • The case report presents a unique situation: an uncommon etiology of neonatal meningitis and favorable evolution, despite neurological sequels reported in the literature.[ncbi.nlm.nih.gov]
  • However, meningococcal disease presenting as primary myopericarditis in immunocompetent adults is a relatively rare phenomenon. We discuss an unusual presentation of meningococcal disease and the investigation and treatment strategies implemented.[ncbi.nlm.nih.gov]
  • A 68-year-old man presented with facial cellulitis and found to have Neisseria meningitidis bacteraemia with no evidence of infection outside of the facial soft tissue.[ncbi.nlm.nih.gov]
  • 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.[ncbi.nlm.nih.gov]
  • We report the case of a 1-year old girl who presented with a painful, swollen right knee, accompanied by fever and agitation.[ncbi.nlm.nih.gov]
Plethora
  • In addition, we discuss the plethora of novel vaccinology approaches that have been applied to the meningococcus with varying success in pre-clinical studies, but which provide technological platforms for application to other pathogens.[ncbi.nlm.nih.gov]
Hoarseness
  • A 78-year-old female patient presented to our emergency department with a 5-day history of throat pain, hoarseness and a progressive and dolorous submandibular swelling.[ncbi.nlm.nih.gov]
  • An 89-year-old woman was referred with worsening symptoms of dysphagia, hoarseness and neck discomfort. After nasopharyngoscopy and neck X-ray, supraglottitis was diagnosed.[ncbi.nlm.nih.gov]
Dysphagia
  • An 89-year-old woman was referred with worsening symptoms of dysphagia, hoarseness and neck discomfort. After nasopharyngoscopy and neck X-ray, supraglottitis was diagnosed.[ncbi.nlm.nih.gov]
Scotoma
  • This corresponded to a deep scotoma similar in size to the physiologic blind spot on Humphrey visual field 24-2 testing.[ncbi.nlm.nih.gov]
Eye Pain
  • A 49-year-old man (Patient 1) and a 22- year-old man (Patient 2) both experienced eye pain and were found to have corneal ulcers with surrounding infiltrate and ground-glass appearance. Gram-negative diplococci were seen in the first case.[ncbi.nlm.nih.gov]
Anterior Uveitis
  • We describe an exceptional case of an immunocompetent 15-month-old child presenting with a unilateral anterior uveitis, hypopyon, and sepsis.[ncbi.nlm.nih.gov]
Cutaneous Manifestation
  • Two patients presented with fever together with systemic and cutaneous manifestations suggestive of CM.[ncbi.nlm.nih.gov]
Urethral Discharge
  • An adult male presented to the Hawaii Health Department with a purulent urethral discharge. Urethral Gram stain examination led to a presumptive gonorrhea diagnosis even though his sexual history was nonsupportive.[ncbi.nlm.nih.gov]
  • Most had urethral discharge (91%), reported oral sex with a female in the last 12 months (96%), and were treated with a ceftriaxone-based regimen (95%). A minority (15%) also had urethral chlamydia coinfection.[ncbi.nlm.nih.gov]

Workup

  • (See Pathophysiology, Etiology, and Workup.) Gram-negative intracellular diplococci. Courtesy Professor Chien Liu.[emedicine.medscape.com]
Ground Glass Appearance
  • A 49-year-old man (Patient 1) and a 22- year-old man (Patient 2) both experienced eye pain and were found to have corneal ulcers with surrounding infiltrate and ground-glass appearance. Gram-negative diplococci were seen in the first case.[ncbi.nlm.nih.gov]
Human Papillomavirus
  • OBJECTIVES: This study addressed knowledge of Streptococcus pneumoniae, Neisseria meningitidis and human papillomavirus (HPV), and attitudes and behaviours towards vaccines against them. STUDY DESIGN: This is a cross-sectional, multicentre study.[ncbi.nlm.nih.gov]

Treatment

  • Diagnosis is a clinical challenge, requiring diagnostic sampling and treatment from both pediatricians and ophthalmologists. Delayed or incorrect treatment risks blindness, disability, or death.[ncbi.nlm.nih.gov]
  • Early recognition and treatment is required to prevent joint destruction.[ncbi.nlm.nih.gov]
  • Prompt treatment comprised nebulised adrenaline, oxygen therapy and intravenous antibiotics. Microbiology samples grew N meningitidis, a notifiable disease in the UK.[ncbi.nlm.nih.gov]
  • Our experience with this patient suggests that susceptibility testing should be performed in every case of N meningitidis isolation, and treatment with a third-generation cephalosporin should be provided until the susceptibility results are known.[ncbi.nlm.nih.gov]
  • The infection may potentially fatal if systemic invasion occurred, however with immediate and proper treatment the outcome is satisfactory. Early diagnosis and proper antibiotic treatment are critical to prevent systemic spread of the infection.[ncbi.nlm.nih.gov]

Prognosis

  • […] poor prognosis include shock, young and old age, coma, purpura fulminans, and disseminated intravascular coagulation Presentation Symptoms headache fever neck stiffness nausea and vomiting myalgias Physical petechial rash nuchal rigidity Brudzinki sign[medbullets.com]
  • Prognosis is much worse if infection has a septicemic component.[ncbi.nlm.nih.gov]
  • Isolated meningococcal meningitis (5% mortality rate) has a better prognosis than meningococcal septicemia (10%-40% mortality rate).[emedicine.medscape.com]
  • Information about the disease must be given out in an attempt to improve the prognosis, including early treatment with parenteral antibiotics and training of the communities' health agents to recognize a suggestive rash.[scielo.br]

Etiology

  • Etiological diagnosis then mainly relies on PCR. Here, we report a case of false-negative results for real-time PCR for a Neisseria meningitidis serogroup B isolate with a polymorphism in the ctrA gene.[ncbi.nlm.nih.gov]
  • The status of the patient improved with etiology-based antimicrobial therapy. This case demonstrates difficulties associated with clinical and microbiological diagnosis of primary septic meningococcal arthritis.[ncbi.nlm.nih.gov]
  • The case report presents a unique situation: an uncommon etiology of neonatal meningitis and favorable evolution, despite neurological sequels reported in the literature.[ncbi.nlm.nih.gov]
  • This can result in urethritis, akin to the syndrome caused by its sister species, N. gonorrhoeae , the etiologic agent of gonorrhea.[ncbi.nlm.nih.gov]
  • Neisseria meningitidis is a rare etiology of keratoconjunctivitis and its ocular presentations are quite similar with other bacterial or viral infection.[ncbi.nlm.nih.gov]

Epidemiology

  • Meningitis, Meningococcal/microbiology* Molecular Typing Neisseria meningitidis/genetics* Neisseria meningitidis/isolation & purification Neisseria meningitidis, Serogroup C/genetics* Neisseria meningitidis, Serogroup C/isolation & purification Niger/epidemiology[ncbi.nlm.nih.gov]
  • This case report highlights the clinical similarities and differing epidemiology of these Neisseria urethritides.[ncbi.nlm.nih.gov]
  • Determination of the genome sequence of the prevalent genotype strain will help us understand the genetic background of the evolutionary and epidemiological properties of these bacteria.[ncbi.nlm.nih.gov]
  • The most likely epidemiological link was simultaneous hospitalization, resulting in indirect nosocomial transmission.[ncbi.nlm.nih.gov]
  • The cases were in their mid-teens to early thirties and were notified to the epidemiological surveillance system of Andalusia (Sistema de Vigilancia Epidemiológica de Andalucía, SVEA) during a 68-day period from March through May 2011.[ncbi.nlm.nih.gov]
Sex distribution
Age distribution

Pathophysiology

  • Modification of subarachnoid space inflammation by anti-inflammatory agents may lessen many of the pathophysiologic consequences of bacterial meningitis.[ncbi.nlm.nih.gov]
  • As such, it represents a unique human infectious disease, because the pathophysiologic effects of disease progression and suboptimal outcomes occur despite bacteriologic cure of the infection. 1 Specifically, the mortality rate for adults who have Streptococcus[nejm.org]
  • Pathogenesis and pathophysiology of bacterial meningitis. Clin Microbiol Rev 1993 ; 6 : 118 –36. Quagliarello V , Scheld WM. Bacterial meningitis: pathogenesis, pathophysiology, and progress. N Engl J Med 1992 ; 327 : 864 –72. Welch SB , Nadel S.[adc.bmj.com]
  • Although capillary leak is the most important clinical event, the underlying pathophysiology is unclear.[emedicine.medscape.com]
  • Pathogenesis and pathophysiology of bacterial meningitis. Clin Microbiol Rev 6, 118 –136. [Google Scholar] 120. Tyski, S., Grzybowska, W., Dulny, G., Berthelsen, L. & Lind, I. ( 2001 ;).[jmm.microbiologyresearch.org]

Prevention

  • Author information 1 State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China. 2 Zhejiang[ncbi.nlm.nih.gov]
  • Use of N. meningitidis C vaccines in a preventive strategy thus should be considered, in particular as most reactive vaccine response strategies in our analysis had little impact on disease burden. 2016 The Authors.[ncbi.nlm.nih.gov]
  • FUNDING: MenAfriNet consortium, a partnership between the US Centers for Disease Control and Prevention, WHO, and Agence de Médecine Preventive, through a grant from the Bill & Melinda Gates Foundation. Copyright 2016 World Health Organization.[ncbi.nlm.nih.gov]
  • Early diagnosis and proper antibiotic treatment are critical to prevent systemic spread of the infection. Public health intervention is needed to prevent outbreak of the disease.[ncbi.nlm.nih.gov]
  • Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA 30333. 5 Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, IN 46202. 6 Department of Global Health, Rollins School of Public Health[ncbi.nlm.nih.gov]

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