PMID- 31128585
OWN - NLM
STAT- MEDLINE
DCOM- 20191220
LR  - 20191220
IS  - 2328-5273 (Electronic)
IS  - 2328-4633 (Linking)
VI  - 77
IP  - 2
DP  - 2019 Mar
TI  - Primary Meningococcal Septic Arthritis Case Report and Literature Review of an 
      Unusual Manifestation of Meningococcal Disease.
PG  - 140-145
AB  - INTRODUCTION: Primary meningococcal septic arthritis (PMSA) is an unusual 
      manifestation of meningococcal disease. It is defined as the presence of acute 
      septic arthritis without association with meningitis or the classic 
      meningococcemia and isolation of Neisseria meningitidis in synovial fluid and 
      blood culture. Diagnosis and early treatment, combining antibiotic and joint 
      drainage, are fundamental. CASE PRESENTATION: We present the case of a healthy 
      17-year-old male who presented with history of an acute onset, painful knee 
      accompanied by fever. N. meningitidis was cultured from the synovial fluid. He 
      was treated with arthroscopic lavage and intravenous ceftriaxone for 2 weeks. He 
      was discharged 7 days after admission receiving outpatient intravenous 
      ceftriaxione for 6 days and was ultimately transitioned to oral ciprofloxacin for 
      2 weeks thereafter. At the final follow-up visit, he had returned to sports 
      activity with a normal knee joint. LITERATURE REVIEW: We have done an exhaustive 
      literature review in PubMed. Forty-four articles were included, with a total of 
      46 patients, to which we added ours. We collected the available demographic data, 
      analytical values, culture tests, treatment, and evolution. PURPOSES AND CLINICAL 
      RELEVANCE: This case illustrates an unusual presentation of N. meningitidis 
      infection. Diagnostic suspicion is essential. Joint washing and antibiotics are 
      the mainstays of treatment. Early and proper treatment prevents complications and 
      mortality. Our main objective was to evaluate the diagnostics tools and treatment 
      in PMSA. As a secondary objective, we evaluated the cases with negative cultures 
      in order to evaluate the criteria for the diagnostic suspicion of PMSA.
FAU - Gomez, Borja Occhi
AU  - Gomez BO
FAU - Feito, Cesar Ramirez
AU  - Feito CR
FAU - Vazquez, Diego Garcia-German
AU  - Vazquez DG
FAU - Vega, Marta Garcia
AU  - Vega MG
FAU - Garcia Viejo, Miguel Angel
AU  - Garcia Viejo MA
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Bull Hosp Jt Dis (2013)
JT  - Bulletin of the Hospital for Joint Disease (2013)
JID - 101614130
RN  - 0 (Anti-Bacterial Agents)
RN  - 75J73V1629 (Ceftriaxone)
SB  - IM
MH  - Administration, Intravenous
MH  - Adolescent
MH  - Anti-Bacterial Agents/administration & dosage
MH  - *Arthritis, Infectious/diagnosis/microbiology/physiopathology/therapy
MH  - Arthroscopy/*methods
MH  - Ceftriaxone/*administration & dosage
MH  - Humans
MH  - *Knee Joint/diagnostic imaging/microbiology
MH  - Male
MH  - *Meningococcal Infections/diagnosis/physiopathology/therapy
MH  - Neisseria meningitidis/*isolation & purification
MH  - Recovery of Function
MH  - Return to Sport
MH  - Synovial Fluid/*microbiology
MH  - Therapeutic Irrigation/*methods
MH  - Treatment Outcome
EDAT- 2019/05/28 06:00
MHDA- 2019/12/21 06:00
CRDT- 2019/05/27 06:00
PHST- 2019/05/27 06:00 [entrez]
PHST- 2019/05/28 06:00 [pubmed]
PHST- 2019/12/21 06:00 [medline]
PST - ppublish
SO  - Bull Hosp Jt Dis (2013). 2019 Mar;77(2):140-145.