奈瑟氏脑膜炎菌血清群W引起幼儿原发性脑膜炎球菌感染性关节炎及文献回顾

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摘要

自2009年以来,欧洲由血清型脑膜炎球菌(MenW:cc11)引起的脑膜炎球菌感染数量急剧增加。众所周知,侵袭性脑膜炎球菌病通常会导致严重败血症或脑膜炎,尽管进行了适当的抗菌治疗,但总死亡率仍高达10%。局灶性感染,如关节炎,是全身性疾病的并发症。方法我们报告一例罕见的2岁原发性脑膜炎球菌性W135关节炎病例。结果患者在麻醉状态下行右踝关节穿刺,产生大量脓性液体,行关节切开术并引流。滑液培养显示脑膜炎奈瑟菌。经手术引流及静脉抗生素治疗后病情好转。1个月后完全康复。讨论。非典型临床表现与较高的病死率相关,并可能导致误诊。侵袭性脑膜炎球菌感染的不寻常表现和细菌的早期识别,加上正确的治疗,可以预防并发症甚至死亡。
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Neisseira meningitidis Serogroup W causing primary meningococcal septic arthritis in a toddler and review of the literature
Since 2009, there has been a serious increase in the number of meningococcal infections in Europe caused by the serotype W meningococcus (MenW:cc11). Invasive meningococcal disease is typically known to cause severe sepsis or meningitiswith high overall mortality rates of 10% despite adequate antimicrobial treatment. Focal infections such as arthritis incidentally occur as a complication of systemic disease. Method We describe a rare case of primary meningococcal W135 arthritis in a 2-year-old patient. Results Arthrocentesis of the right Ankle while patient was under anesthesia, yielded grossly purulent fluid, so we made arthrotomy and drainage. The culture from synovial fluid revealed N. meningitidis.The status of the patient improved after surgical drainage and intravenous antibiotic therapy. She recovered completely after 1 month. Discussion.Atypical clinical presentation is associated with higher case fatality rates and can lead to misdiagnoses.an unusual presentation of invasive meningococcal infection and the early identification of the bacteria, combined with the correct treatment, prevent the complications and even death.
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