Is primary meningococcal arthritis in children more frequent than we expect? Two pediatric case reports revealed by molecular test.

Authors:
S Ricci
S Ricci
Università Sapienza
Italy

BMC Infect Dis 2018 Dec 27;18(1):703. Epub 2018 Dec 27.

Immunology Division, Section of Pediatrics, Department of Health Sciences, University of Florence and Meyer Children's University Hospital, Florence, Italy.

Background: 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 ]. There are no validated clinical criteria that can be used for the diagnosis. We present two pediatric cases of atypical presentation of meningococcal disease revealed by molecular tests.

Case Presentation: The clinical presentation of the two children (6- and 9-years-old) was characterized by signs of arthritis. By Real Time Polymerase Chain Reaction (RT-PCR), we identified N. meningitidis serogroup Y in the joint fluid in both cases. After specific antimicrobial treatment, the clinical conditions of the two patients quickly improved during hospitalization.

Conclusions: We believe that the incidence of meningococcal arthritis could be underestimated in those settings where the use of RT-PCR is limited. Clearer data on the incidence of meningococcal disease would help to design specific treatments and the best possible national vaccine strategies [Fiji Sci Rep 23:39784, 2016, J Infect 67:385-90, 2013].

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https://bmcinfectdis.biomedcentral.com/articles/10.1186/s128
Publisher Site
http://dx.doi.org/10.1186/s12879-018-3602-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6307139PMC

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December 2018
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