Neisseira meningitidis Serogroup W causing primary meningococcal septic arthritis in a toddler and review of the literature

Abstract

Since 2009, there has been a serious increase in the number of meningococcal infections in Europe caused by the serotype W meningococcus (MenW:cc11). Invasive meningococcal disease is typically known to cause severe sepsis or meningitiswith high overall mortality rates of 10% despite adequate antimicrobial treatment. Focal infections such as arthritis incidentally occur as a complication of systemic disease. Method We describe a rare case of primary meningococcal W135 arthritis in a 2-year-old patient. Results Arthrocentesis of the right Ankle while patient was under anesthesia, yielded grossly purulent fluid, so we made arthrotomy and drainage. The culture from synovial fluid revealed N. meningitidis.The status of the patient improved after surgical drainage and intravenous antibiotic therapy. She recovered completely after 1 month. Discussion.Atypical clinical presentation is associated with higher case fatality rates and can lead to misdiagnoses.an unusual presentation of invasive meningococcal infection and the early identification of the bacteria, combined with the correct treatment, prevent the complications and even death.