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    Peripheral blood vessels are a niche for blood-borne meningococci.
    Virulence 2017 Nov 3. Epub 2017 Nov 3.
    a Institut Necker Enfants-Malades, INSERM U1151, Equipe 11 , Paris , France.
    Neisseria meningitidis is the causative agent of cerebrospinal meningitis and that of a rapidly progressing fatal septic shock known as purpura fulminans. Meningococcemia is characterized by bacterial adhesion to human endothelial cells of the microvessels. Host specificity has hampered studies on the role of blood vessels colonization in N. Read More

    Combined effect of PCV10 and meningococcal C conjugate vaccination on meningitis mortality among children under five years of age in Brazil.
    Hum Vaccin Immunother 2017 Oct 25. Epub 2017 Oct 25.
    e Institute of Tropical Pathology and Public Health, Federal University of Goias , Goiania , Goias , Brazil.
    The 10-valent pneumococcal conjugate vaccine (PCV10) was introduced in the Brazilian National Immunization Program in March 2010, scheduled at 2, 4, and 6 months, with a booster at 12-15 months of age. The meningococcal C conjugate vaccine (MCC) was introduced in November 2010, scheduled at 3 and 5 months, with a booster dose at 12-15 months of age and no catch-up for older age groups. In this interrupted time-series analysis study, we used Brazilian mortality data from 2005 to 2015 for children under five years of age (excluding data from the state of Bahia) to assess the combined impact of these vaccines on the overall burden of meningitis mortality among children aged 0-23 months and 2-4 years, as defined using meningitis and meningococcemia specific International Classification of Diseases - tenth revision codes. Read More

    Fever with Rashes.
    Indian J Pediatr 2017 Sep 23. Epub 2017 Sep 23.
    Department of Pediatrics, Pushpagiri Institute of Medical Sciences and Research Center, Thiruvalla, Kerala, India.
    Fever with rashes is one of the commonest clinical problems a general practitioner or pediatrician has to face in day-to-day clinical practice. It can be a mild viral illness or a life-threatening illness like meningococcemia or Dengue hemorrhagic fever or it can be one with a lifelong consequence like Kawasaki disease. It is very important to arrive at a clinical diagnosis as early as possible with the minimum investigational facilities. Read More

    Mutilating Purpura Fulminans in an Adult with Meningococcal Sepsis.
    P R Health Sci J 2017 Sep;36(3):179-182
    Department of Radiology, Aspetar-Orthopaedic and Sports Medicine Hospital, Al Buwairda St. Doha, Qatar.
    We report a dramatic case of meningococcal sepsis manifesting as purpura fulminans in an elderly diabetic woman. Hemodynamic instability and severe bilateral cutaneous lesions involving her hands and feet developed rapidly. Specific antibiotic therapy and the administration of inotropic and vasopressor drugs were initiated. Read More

    Genomic characterization of urethritis-associated Neisseria meningitidis shows that a wide range of N. meningitidis strains can cause urethritis.
    J Clin Microbiol 2017 Sep 13. Epub 2017 Sep 13.
    Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, USA
    Neisseria meningitidis, typically a resident of the oro- or nasopharynx and the causative agent of meningococcal meningitis and meningococcemia, is capable of invading and colonizing the urogenital tract. This can result in urethritis, akin to the syndrome caused by its sister species N. gonorrhoeae, the etiologic agent of gonorrhea. Read More

    A Case of Fulminant Meningococcemia: It Is All in the Complement.
    Case Rep Infect Dis 2017 20;2017:6093695. Epub 2017 Jul 20.
    Division of Infectious Disease, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
    Eculizumab is a novel monoclonal antibody that inhibits complement-mediated hemolysis in patients with paroxysmal nocturnal hemoglobinuria (PNH). Complement deficiency is a well-known risk factor for meningococcal infection. We describe a case of a young patient with PNH treated with eculizumab who presented with a life-threatening case of nongroupable meningococcemia. Read More

    Arthritis secondary to meningococcal disease: A case series of 7 patients.
    Medicine (Baltimore) 2017 Jul;96(29):e7573
    aUniversité Paris Diderot, Sorbonne Paris Cité, UFR de Médecine bAP-HP, Service de Rhumatologie, Hôpital Bichat cUniversité Paris Diderot, Sorbonne Paris Cité, UFR de Médecine dAP-HP, Service de Bactériologie-Virologie, Hôpital Lariboisière eUniversité Paris Diderot, Sorbonne Paris Cité, UFR de Médecine fAP-HP, Service de Rhumatologie, Hôpital Lariboisière gService de Rhumatologie et Médecine Interne. Centre de Référence des Infections Ostéo-articulaire complexes. Groupe hospitalier Diaconesses Croix St-Simon hUniversité Paris Diderot, Sorbonne Paris Cité, UFR de Médecine iAP-HP, Service de Maladie infectieuses, Hôpital Bichat, Paris, France.
    Arthritis secondary to invasive meningococcemia is rare and has been described as a direct result of bacteremia or as immunoallergic-type arthritis, related to the immune complex. Only a few case series have been reported.This multicenter study aimed to describe the clinical characteristics and therapeutic outcomes of arthritis secondary to meningococcal infection. Read More

    Atriobronchial Fistula Complicated by Septic Cerebral Air Emboli After Pulmonary Vein Ablation.
    Crit Care Med 2017 Aug;45(8):e867-e871
    1Department of Anesthesia and Reanimation, ZNA Middelheim Hospital, Antwerpen, Belgium.2Department of Cardiothoracic Surgery, ZNA Middelheim Hospital, Antwerpen, Belgium.3Department of Critical Care, ZNA Middelheim Hospital, Antwerpen, Belgium.
    Objective: To describe a case of an infected atriobronchial fistula as a late complication after pulmonary vein ablation, leading to septic air emboli and requiring urgent cardiac surgery.

    Data Sources: Clinical observation.

    Study Selection: Case report. Read More

    School Nurses on the Front Lines of Medicine: Connecting the Dots: SCRIPTS for Success in the Evaluation of Pediatric Rashes.
    NASN Sch Nurse 2017 May;32(3):172-177
    Attending Pediatric Emergency Medicine Physician, Penn State Hershey Medical Center, Hershey, PA.
    Although skin rashes may not necessarily prompt a visit to the school nurse's office, a rash associated with other systemic symptoms, such as fever, headache, difficulty swallowing or breathing, weakness, or abdominal pain, may cause a child to visit your office. This article describes the initial assessment and management of skin rashes in children and adolescents and delineates reasons that may prompt the school nurse to transfer a student with a rash to a local emergency department. Read More

    Acute polyarthritis in a young patient caused by meningococcal and parvovirus B19 infections: a case report and review of the literature.
    J Med Case Rep 2016 Dec 20;10(1):362. Epub 2016 Dec 20.
    Service de Maladies Infectieuses Aigues, Pôle Maladies Infectieuses, Assistance Publique Hôpitaux de Marseille, CHU Timone, Institut Hospitalo-Universitaire Méditerranée Infection, 13005, Marseille, France.
    Background: Meningococcal infection is a multifaceted disease including acute polyarthritis. This presentation should be known by clinicians in order to prevent delay in treatment. We report what we believe to be the first case of an association of parvovirus B19 and meningococcal polyarthritis in a young adult. Read More

    Meningococcal Disease in Children in Argentina A 3-year Active Sentinel Hospital Surveillance Study.
    Pediatr Infect Dis J 2017 Mar;36(3):296-300
    From the *Epidemiology Unit, Ricardo Gutiérrez Children's Hospital, Buenos Aires, Argentina; †Infectious Disease Unit, Sor María Ludovica Children's Hospital, La Plata, Argentina; ‡Infectious Disease Unit, Victor Vilela Children's Hospital, Rosario, Argentina; §Infectious Disease Unit, Humberto Notti Pediatric Hospital, Mendoza, Argentina; ¶Infectious Disease Unit, Juan Pablo II Pediatric Hospital, Corrientes, Argentina; ‖Infectious Disease Unit, Eva Perón Children's Hospital, Catamarca, Argentina; **Bacteriology Unit, INEI-ANLIS "Dr. Carlos G. Malbrán"; and ††Infectious Disease Unit, FUNCEI, Buenos Aires, Argentina.
    Background: Meningococcal disease (MD) is a medical emergency and a serious public health problem. As new meningococcal vaccines become available, MD surveillance is crucial to provide baseline epidemiologic data before implementing preventive measures. We estimated MD incidence and epidemiology in Argentina using hospital-based surveillance. Read More

    Successful treatment of a patient with ethylmalonic encephalopathy by intravenous N-acetylcysteine.
    Metab Brain Dis 2017 Apr 9;32(2):293-296. Epub 2016 Nov 9.
    Pediatric Neurology Unit, Sami Ulus Children Hospital, Ankara, Turkey.
    Ethylmalonic encephalopathy (EE) is an autosomal recessive devastating metabolic disorder affecting the brain, gastrointestinal tract, peripheral vessels and rarely the other vascular organs. We report a 10-month-old girl who presented as a meningococcemia clinic but later diagnosed ethylmalonic encephalopathy. Molecular analyses revealed a homozygous c. Read More

    Infections and Thrombocytopenia.
    J Assoc Physicians India 2016 Feb;64(2):11-12
    Febrile patient with thrombocytopenia is commonly encountered by physicians especially during monsoon and perimonsoon period. Infections with protozoa, bacteria and viruses can cause thrombocytopenia with or without disseminated intravascular coagulation. Commonly dengue, malaria, scrub typhus and other rickettsial infections, meningococci, leptospira and certain viral infections present as fever with thrombocytopenia. Read More

    Meningococcal pneumonia in Japan: A case report and literature review.
    J Infect Chemother 2016 Dec 1;22(12):833-836. Epub 2016 Sep 1.
    Department of Infectious Diseases, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Japan.
    Neisseria meningitidis often causes meningitis and meningococcemia; however, meningococcal pneumonia is quite rare. Herein, we report a case of non-invasive meningococcal pneumonia initially misdiagnosed as pneumonia due to Moraxella catarrhalis on the basis of a Gram stain in a 43-year-old woman with asthma, type 2 diabetes mellitus, and schizophrenia. She visited our hospital following a 3-day history of fever, productive cough, and shortness of breath. Read More

    Experimental Evidence of Bacterial Colonization of Human Coronary Microvasculature and Myocardial Tissue during Meningococcemia.
    Infect Immun 2016 Oct 19;84(10):3017-23. Epub 2016 Sep 19.
    INSERM, U1151, Institut Necker Enfants Malades, Paris, France Université Paris Descartes, Sorbonne Paris Cité, Paris, France Laboratoire de Microbiologie Hôpital Necker-Enfants malades, Assistance Publique-Hôpitaux de Paris, Paris, France.
    Meningococcal septic shock is associated with profound vasoplegia, early and severe myocardial dysfunction, and extended skin necrosis responsible for a specific clinical entity designated purpura fulminans (PF). PF represents 90% of fatal meningococcal infections. One characteristic of meningococcal PF is the myocardial dysfunction that occurs in the early phase of sepsis. Read More

    [Two case reports of meningococcemia. Review of the literature on chronic meningococcemia].
    Arch Pediatr 2016 Jun 25;23(6):595-8. Epub 2016 Apr 25.
    Service universitaire de pédiatrie, CHU-CHR La Citadelle, université de Liège, 4000 Liège, Belgique.
    Introduction: Neisseria meningitidis is a Gram-negative bacteria that can be highly pathogenic in humans and responsible for life-threatening and acute diseases. In a few cases, it can lead to an atypical form of sepsis-acute, subacute, or chronic-which, even if progression is slower, may carry the same risks for patients as conventional acute forms.

    Cases: Case 1 presented with recurrent fever, polyarthralgia, and generalized macular rash. Read More

    Clinical laboratory standard capillary protein electrophoresis alerted of a low C3 state and lead to the identification of a Factor I deficiency due to a novel homozygous mutation.
    Immunol Lett 2016 Jun 14;174:19-22. Epub 2016 Apr 14.
    Immunology Division, Hospital Universitari Vall d'Hebron (HUVH), Vall d'Hebron Research Institute (VHIR), Barcelona, Spain; Department of Cell Biology, Physiology and Immunology, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain.
    Complement factor I (CFI) deficiency is typically associated to recurrent infections with encapsulated microorganisms and, less commonly, to autoimmunity. We report a 53-years old male who, in a routine control for non-alcoholic fatty liver disease, presented a flat beta-2 fraction at the capillary protein electropherogram. Patient's clinical records included multiple oropharyngeal infections since infancy and an episode of invasive meningococcal infection. Read More

    Meningococcemia in Adults: A Review of the Literature.
    Intern Med 2016 15;55(6):567-72. Epub 2016 Mar 15.
    Department of General Internal Medicine, Nara City Hospital, Japan.
    We mainly refer to the acute setting of meningococcemia. Meningococcemia is an infection caused by Neisseria meningitidis, which has 13 clinically significant serogroups that are distinguishable by the structure of their capsular polysaccharides. N. Read More

    Acute hemorrhagic edema of infancy and common mimics.
    Am J Emerg Med 2016 May 25;34(5):936.e3-6. Epub 2015 Sep 25.
    Department of Emergency Medicine, Division of Pediatric Emergency Medicine, Mayo Clinic, Rochester, MN 55905.
    Acute hemorrhagic edema of infancy (AHEI) is a rare acute benign cutaneous leukocytoclastic vasculitis affecting children younger than 24 months of age. Its presentation can be confused with those of urticaria, erythema multiforme, Henoch-Schönlein purpura, idiopathic thrombocytopenia,meningococcemia, Kawasaki disease, and drug rash. We present 2 cases of acute hemorrhagic edema of infancy, discuss the characteristics of AHEI, and compare and contrast AHEI with similar dermatologic presentations. Read More

    Meningococcemia Presenting as a Myocardial Infarction.
    Case Rep Crit Care 2015 11;2015:953826. Epub 2015 Nov 11.
    Division of Pulmonary and Critical Care Medicine, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14624, USA.
    Neisseria meningitidis is an encapsulated gram negative diplococcus that colonizes the nasopharynx and is transmitted by aerosol or secretions with the majority of cases occurring in infants and adolescents. Meningococcemia carries a high mortality which is in part due to myocarditis. Early recognition and prompt use of antibiotics improve morbidity and mortality. Read More

    [Clinical features and prognostic factors of meningococcal disease: a case series study in Chile during the 2012-2013 outbreak].
    Rev Chilena Infectol 2015 Oct;32(5):505-16
    Introduction: Meningococcal disease (MD) is a major global problem because of its case fatality rate and sequels. Since 2012 cases of serogroup W have increased in Chile, with nonspecific clinical presentation, high case fatality rate and serious consequences.

    Objective: To characterize the evolution and outcome of MD cases between January 2012 and March 2013 in Chile. Read More

    [Meningococcemia without meningitis: A report of two cases].
    Rev Med Interne 2016 Mar 31;37(3):206-8. Epub 2015 Aug 31.
    Service de dermatologie, centre hospitalier de Saint-Brieuc, 10, rue Marcel-Proust, 22000 Saint-Brieuc, France. Electronic address:
    Introduction: Meningococcemia without meningitis is an often under recognized clinical form of invasive Neisseria meningitidis infection.

    Case Reports: We report two unusual cases of invasive meningococcal disease who presented with meningococcemia without distinct signs of meningitis or severe sepsis manifestation. In both cases, confirmation of the diagnosis is provided by meningococcal PCR performed on blood or skin lesion biopsy. Read More

    Chronic meningococcemia presenting as a recurrent painful rash without fever in a teenage girl.
    Pediatr Infect Dis J 2015 Jun;34(6):670-2
    From the Department of Pediatrics, State University of New York Upstate Medical University, Syracuse, NY.
    Chronic meningococcemia is a rare diagnosis seen in patients with recurrent fever and rash. We describe a case of chronic meningococcemia in a teenage girl who presented with a recurrent painful rash, without fever, over a period of 8 weeks. Read More

    [Fever with a rash caused by chronic meningococcemia].
    Ned Tijdschr Geneeskd 2015 ;159:A8103
    Afd. Kindergeneeskunde: J.C. de Jonge, coassistent kindergeneeskunde; dr. K. Koop, aios kindergeneeskunde; drs. R. Nuboer, kinderarts.
    Background: Fever with a rash is a common clinical presentation, which can be caused by various medical conditions.

    Case Description: A 14-year old boy presented at the outpatient clinic with a two-week history of fever, myalgia and purpuric skin lesions. Blood cultures showed an infection with Neisseria meningitidis. Read More

    A very rare case of primary meningococcal arthritis in an adult male.
    Clin Case Rep 2015 Feb 6;3(2):76-80. Epub 2014 Oct 6.
    Kitasato Institute for Life Sciences and Laboratory for Antimicrobial Agents, Kitasato University 1-15-1 Kitasato, Sagamihara, Kanagawa, 252-0373, Japan.
    We report here a very rare case of primary meningococcal arthritis of the knee joint without clinical features associated with meningococcemia, meningitis, or meningococcal complications. The patient suffered from diabetes mellitus and had experienced two episodes of joint trauma. Intravenous infusion of ampicillin/sulbactam for 18 consecutive days was successful. Read More

    First case of Neisseria meningitidis capsule null locus infection in China.
    Infect Dis (Lond) 2015 Aug 2;47(8):591-2. Epub 2015 Mar 2.
    From the 1 National Institute for Communicable Disease Control and Prevention, and State Key Laboratory for Infectious Disease Prevention and Control, Chinese Center for Disease Control and Prevention , Beijing , PR China.
    Invasive meningococcal diseases are rarely caused by capsule null locus (cnl) strains, which are unencapsulated owing to an absence of capsule synthesis genes. Only a few cases of cnl meningococcemia in severely immunocompromised patients have been reported. Here, we describe and discuss the first case of invasive disease in an immunocompetent patient due to a cnl strain of Neisseria meningitidis in China. Read More

    [Septic vasculitis caused by Listeria monocytogenes].
    Rev Chilena Infectol 2014 Dec;31(6):746-9
    Septic vasculitis is a medium and small-vessel vasculitis caused by direct action of pathogens, associated with bacteremia. It is an uncommon condition; clinical manifestations include purpura, ulcers and vesicles-pustules. Most cases of septic vasculitis are related to meningococcemia. Read More

    Radiology preparedness in ebola virus disease: guidelines and challenges for disinfection of medical imaging equipment for the protection of staff and patients.
    Radiology 2015 May 5;275(2):538-44. Epub 2015 Feb 5.
    From the Center for Infectious Disease Imaging (D.J.M., D.A.B.), Department of Radiology and Imaging Sciences, Clinical Center (D.J.M., L.R.F., D.A.B.), and Clinical Center Hospital Epidemiology Service (T.N.P.), National Institutes of Health, 10 Center Dr, Building 10, Room 1C349, Mailstop 1182, Bethesda, MD 20892.
    The overlap of early Ebola virus disease (EVD) symptoms (eg, fever, headache, abdominal pain, diarrhea, emesis, and fatigue) with symptoms of other more common travel-related diseases (eg, malaria, typhoid fever, pneumonia, and meningococcemia) may result in delayed diagnosis of EVD before isolation of infected patients. Radiology departments should consider policies for and approaches to decontamination of expensive and potentially easily damaged radiology equipment. In addition, the protection of radiology personnel must be considered during the work-up phase of undiagnosed EVD patients presenting to emergency departments. Read More

    Septic vasculitis and vasculopathy in some infectious emergencies: the perspective of the histopathologist.
    G Ital Dermatol Venereol 2015 Feb 16;150(1):73-85. Epub 2015 Jan 16.
    Department of Medical Sciences and Human Oncology, Azienda Ospedaliero‑Universitaria, Città della Salute e della Scienza, Turin, Italy -
    Sepsis is a potentially life-threatening complication of an infection where cutaneous lesions often represent one of the early signs. A myriad of microorganisms including bacteria, fungi, yeasts, viruses, protozoas, helminths and algae can be implicated. A broad spectrum of clinical and histopathologic findings can be observed in the skin and the common denominator is a thrombotic vasculopathy. Read More

    [Persistent fever syndrome secondary to brain abscesses: a rare complication of the meningococcemia].
    An Sist Sanit Navar 2014 Sep-Dec;37(3):445-8
    Servicio de Medicina Interna, Hospital de Antequera, Málaga, 29200, Spain.
    Meningococcal disease is caused by hematogenous spreading of Neisseria meningitidis. Meningococcal sepsis occurs in around 20% of cases of meningococcal disease, meningitis in 50% and, to a lesser extent, other conditions such as pneumonia, arthritis, urethritis, conjunctivitis or pericarditis. Brain abscesses are a rare complication. Read More

    Meningococcal meningitis with meningococcemia: a rare sporadic case in an elderly patient with no history of contact with infected individuals.
    Jpn J Infect Dis 2015 25;68(1):67-9. Epub 2014 Nov 25.
    Center for Clinical Infectious Diseases, Jichi Medical University.
    An 89-year-old Japanese woman with no history of contact with infected individuals developed meningococcal meningitis with meningococcemia. Compared with other countries, invasive meningococcal disease is relatively rare in Japan, with an annual incidence of a total of 10-20 cases for more than 2 decades; this represents approximately 1% of the corresponding incidence in the United States and United Kingdom. The most prevalent serotypes of the causative agent Neisseria meningitidis in Japan are serotypes B and Y. Read More

    Staphylococcal Purpura Fulminans: Report of a Case.
    Am J Dermatopathol 2015 Aug;37(8):643-6
    *Department of Pathology; and †Department of Dermatology and Pathology, Smilow Cancer Center, Yale School of Medicine, New Haven, CT.
    Purpura fulminans (PF) is associated with several infections and most commonly with meningococcemia. However, there are only a few reports of this entity in association with toxic shock syndrome toxin-1-producing Staphylococcus aureus. We report a 53-year-old man who presented with fever, progressive hemodynamic instability, multiorgan failure, and thrombocytopenia following lobectomy for a solitary lung metastasis from rectal adenocarcinoma. Read More

    Indian tick typhus presenting as Purpura fulminans.
    Indian J Crit Care Med 2014 Jul;18(7):476-8
    Department of Microbiology, Yashoda Hospital, Secunderabad, Andhra Pradesh, India.
    Seriously ill patients presenting with purpura fulminans, sepsis and multi-organ failure often require extensive diagnostic workup for proper diagnosis and management. Host of common infections prevalent in the tropics, e.g. Read More

    Rutin improves endotoxin-induced acute lung injury via inhibition of iNOS and VCAM-1 expression.
    Environ Toxicol 2016 Feb 1;31(2):185-91. Epub 2014 Aug 1.
    Department of Pharmacology, School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
    Endotoxins exist anywhere including in water pools, dust, humidifier systems, and machining fluids. The major causal factor is endotoxins in many serious diseases, such as fever, sepsis, multi-organ failure, meningococcemia, and severe morbidities like neurologic disability, or hearing loss. Endotoxins are also called lipopolysaccharide (LPS) and are important pathogens of acute lung injury (ALI). Read More

    MBL2 deficiency is associated with higher genomic bacterial loads during meningococcemia in young children.
    Clin Microbiol Infect 2014 Dec 18;20(12):1337-42. Epub 2014 Dec 18.
    Department of Infection and Tropical Medicine, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK; Department of Infection and Immunity, University of Sheffield, Sheffield, UK.
    Mannose binding lectin (MBL2) is a soluble pattern recognition receptor that is key to generating innate immune responses to invasive infection, including against the cardinal Gram-negative bacterium Neisseria meningitidis. Individuals homozygous or heterozygous for any of three variant alleles of MBL2 (O/O or A/O genotypes) have deficient concentrations of MBL2 in circulating blood, but previous studies linking MBL deficiency to susceptibility to meningococcal disease have not revealed a consistent association. We genotyped 741 patients with microbiologically-proven meningococcal disease and correlated MBL2 genotype with plasma bacterial load of N. Read More

    Detection of Neisseria meningitidis from negative blood cultures and cerebrospinal fluid with the FilmArray blood culture identification panel.
    J Clin Microbiol 2014 Jun 16;52(6):2262-4. Epub 2014 Apr 16.
    Department of Pathology, University of Florida, Gainesville, Florida, USA
    The FilmArray blood culture identification (BCID) panel is a rapid molecular diagnostic test approved for use with positive blood culture material. We describe a fatal case of meningococcemia with central nervous system (CNS) involvement detected using the BCID test with culture-negative blood and cerebrospinal fluid. Read More

    Corticosteroid-induced meningococcal meningitis in a patient with chronic meningococcemia.
    JAMA Dermatol 2014 Jul;150(7):752-5
    Importance: Although chronic meningococcemia is an uncommon disorder, it is of great importance to clinicians across multiple disciplines because it presents similarly to reactive, neoplastic, or rheumatic disorders. Ruling out chronic meningococcemia, however, represents a diagnostic challenge because routine microbiological investigations frequently fail to identify Neisseria meningitidis. Although treatment with corticosteroids might be helpful in various conditions, corticosteroid treatment may lead to severe complications in underlying chronic meningococcemia. Read More

    Global practices of meningococcal vaccine use and impact on invasive disease.
    Pathog Glob Health 2014 Jan;108(1):11-20
    A number of countries now include meningococcal vaccines in their routine immunization programs. This review focuses on different approaches to including meningococcal vaccines in country programs across the world and their effect on the burden of invasive meningococcal disease (IMD) as reflected by pre and post-vaccine incidence rates in the last 20 years. Mass campaigns using conjugated meningococcal vaccines have lead to control of serogroup C meningococcal disease in the UK, Canada, Australia, Spain, Belgium, Ireland, and Iceland. Read More

    Photoletter to the editor: Diffuse cocaine-related purpura.
    J Dermatol Case Rep 2013 30;7(4):132-3. Epub 2013 Dec 30.
    University of TennesseeMedical Center, Department of Internal Medicine, 1924 Alcoa Highway, Knoxville, TN 37920, USA.
    Diffuse purpura is an uncommon skin manifestation found in platelet and coagulation disorders, meningococcemia, vasculitides and cocaine use. Reports of cocaine-related purpura predominantly involve adulteration with the anti-helminthic, levamisole. Levamisole enhances the effects of cocaine and is known to cause vasculitis. Read More

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