Chronic meningococcemia in an immunocompetent girl
| Autor: | María J. Méndez‐Bustelo, Emilio Del‐Rio, Josefina Pena |
|---|---|
| Rok vydání: | 1994 |
| Předmět: |
medicine.medical_specialty
Pathology Urinalysis Adolescent Arthritis Physical examination Dermatology Anorexia Neisseria meningitidis medicine.disease_cause Gastroenterology Group B Immunocompromised Host Cerebrospinal fluid Internal medicine medicine Humans Leukocytosis medicine.diagnostic_test business.industry medicine.disease Anti-Bacterial Agents Meningococcal Infections Erythema Chronic Disease Female medicine.symptom business |
| Zdroj: | International journal of dermatology. 33(7) |
| ISSN: | 0011-9059 |
| Popis: | A 13-year-old healthy girl consulted with a 4-week history of recurrent fever (39–40°C) and erythematous macules and plaques on the distal parts of her legs and forearms, and the palms and soles, A migrating arthritis developed on the left ankle and, later, on the knees, elbows, wrists, and hand joints. General symptoms included anorexia, malaise, and weight loss. Physical examination revealed several erythematous macules, plaques, and nodules, 1–3 cm in diameter, located on the anterior and posterior aspects of the legs, soles, forearms, dorsum of the hands, and palms (Fig. 1), Some lesions showed very small petechiae and vesicles in the center. The nodules in acral locations were painful. A hemogram displayed mild anemia (hemoglobin 11.3 g/dL) and leukocytosis (11,500 WBc/mm3). The erythrocyte sedi-mentation rate was 63 mm in 1 hour. Serum biochemistry, protein and protein fractions, and fractions of immunoglobu-lins were within normal limits. Urinalysis showed microhe-maturia and a few leukocytes. Two serial blood cultures were taken during the first two febrile peaks after admission, but both were negative. A third one (1 week after admission) was positive for group B Neisseria meningitidis. This bacterium was also recovered from pharyngeal samples, but was not isolated in the culture of cerebrospinal fluid. Antibiotic therapy was established with intravenous cephtriaxone, 100 mg/kg/day for 10 days, with dramatic im-provement of the fever and arthritis within 3 days. The cu-taneous lesions disappeared within 1 week. Some of the components of complement proteins (C3, C4, and C5) were measured to rule out any deficiency, but they were normal. A normal value of CH50 supported the adequate presence of all of the components of the mem-brane attack complex (C6 to C9) in the serum. Several relatives of the patient were found to be oropha-ryngeal carriers of group B Neisseria meningitidis. They were treated successfully with rifampin (20 mg/kg/day for 2 days). |
| Databáze: | OpenAIRE |
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