PMID- 34850098
OWN - NLM
STAT- MEDLINE
DCOM- 20220627
LR  - 20220628
IS  - 2472-5625 (Electronic)
IS  - 2472-5625 (Linking)
VI  - 6
IP  - 2
DP  - 2022 Jun 24
TI  - Primary meningococcal septic arthritis associated with joint calcium oxalate 
      crystals: A case report and review of the literature.
PG  - 296-300
LID - 10.1093/mrcr/rxab049 [doi]
AB  - Primary meningococcal septic arthritis (PMSA) is an extremely rare local 
      infection by Neisseria meningitidis in the absence of meningitis or 
      meningococcaemia syndrome. A 30-year-old healthy, immunocompetent man presented 
      with arthralgia, fever, chest rash, and significant swelling of the right knee. 
      On admission, a disseminated maculopapular and purpuric rash, oligoarthritis, 
      neutrophilia, and elevated acute phase reactants were documented. Following 
      arthrocentesis of the right knee, isolation of N. meningitidis and the presence 
      of calcium oxalate crystals in the synovial fluid were reported. The diagnosis of 
      PMSA was made. Histological analysis of the skin lesion showed leucocytoclastic 
      vasculitis. He was treated with intravenous ceftriaxone plus open surgical 
      drainage and ambulatory cefixime with adequate response. After 1 month, he 
      presented resolution of the pathological process. We performed an extensive 
      review of the literature, finding that the key elements supporting the diagnosis 
      of PMSA are prodromal upper respiratory tract symptoms and skin involvement prior 
      to or synchronous with the arthritis. Also, the most frequently involved joint is 
      the knee. This report is the first case of a patient presenting with PMSA 
      associated with calcium oxalate crystals in the synovial fluid. Herein, we 
      discuss the most frequent clinical manifestations, the unusual histological 
      features, the recommended treatment, and the reported prognosis of this rare 
      entity.
CI  - (c) Japan College of Rheumatology 2021. Published by Oxford University Press. All 
      rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
FAU - Cime-Ake, Erik
AU  - Cime-Ake E
AUID- ORCID: 0000-0002-7012-8419
AD  - Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas 
      y Nutricion Salvador Zubiran, Mexico City, Mexico.
FAU - Carranza-Enriquez, Fabian
AU  - Carranza-Enriquez F
AD  - Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas 
      y Nutricion Salvador Zubiran, Mexico City, Mexico.
FAU - Hurtado-Arias, Jose Joel
AU  - Hurtado-Arias JJ
AD  - Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas 
      y Nutricion Salvador Zubiran, Mexico City, Mexico.
FAU - Munoz-Castaneda, Wallace Rafael A
AU  - Munoz-Castaneda WRA
AUID- ORCID: 0000-0002-7109-6113
AD  - Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas 
      y Nutricion Salvador Zubiran, Mexico City, Mexico.
FAU - Medina-Fonseca, Benjamin
AU  - Medina-Fonseca B
AD  - Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas 
      y Nutricion Salvador Zubiran, Mexico City, Mexico.
FAU - Barrera-Vargas, Ana
AU  - Barrera-Vargas A
AUID- ORCID: 0000-0002-1754-0500
AD  - Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas 
      y Nutricion Salvador Zubiran, Mexico City, Mexico.
FAU - Lizardo-Thiebaud, Maria J
AU  - Lizardo-Thiebaud MJ
AD  - Department of Pathology, Instituto Nacional de Ciencias Medicas y Nutricion 
      Salvador Zubiran, Mexico City, Mexico.
FAU - Saeb-Lima, Marcela
AU  - Saeb-Lima M
AD  - Department of Pathology, Instituto Nacional de Ciencias Medicas y Nutricion 
      Salvador Zubiran, Mexico City, Mexico.
FAU - Merayo-Chalico, Javier
AU  - Merayo-Chalico J
AUID- ORCID: 0000-0002-5870-0523
AD  - Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas 
      y Nutricion Salvador Zubiran, Mexico City, Mexico.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Review
PL  - England
TA  - Mod Rheumatol Case Rep
JT  - Modern rheumatology case reports
JID - 101761026
RN  - 2612HC57YE (Calcium Oxalate)
SB  - IM
MH  - Adult
MH  - *Arthritis, Infectious/diagnosis/etiology/therapy
MH  - Calcium Oxalate/therapeutic use
MH  - *Exanthema
MH  - Humans
MH  - Male
MH  - *Meningococcal Infections/complications/diagnosis/drug therapy
MH  - *Neisseria meningitidis
OTO - NOTNLM
OT  - Neisseria meningitidis
OT  - Septic arthritis
OT  - arthrocentesis
OT  - calcium oxalate
OT  - synovial fluid
EDAT- 2021/12/02 06:00
MHDA- 2022/06/28 06:00
CRDT- 2021/12/01 07:24
PHST- 2021/08/14 00:00 [received]
PHST- 2021/11/02 00:00 [revised]
PHST- 2021/11/10 00:00 [accepted]
PHST- 2021/12/02 06:00 [pubmed]
PHST- 2022/06/28 06:00 [medline]
PHST- 2021/12/01 07:24 [entrez]
AID - 6437660 [pii]
AID - 10.1093/mrcr/rxab049 [doi]
PST - ppublish
SO  - Mod Rheumatol Case Rep. 2022 Jun 24;6(2):296-300. doi: 10.1093/mrcr/rxab049.