反复发热与皮疹提示慢性脑膜炎球菌血症
[Recurrent fever and skin eruption revealing chronic meningococcemia].
作者信息
Roux M, Sire S, Lalande V, Le Coustumier A, Tiev K-P, Tolédano C, Josselin-Mahr L, Gain M, Cabane J, Kettaneh A
机构信息
Service de médecine interne, hôpital Saint-Antoine, Assistance publique-Hôpitaux de Paris, université Pierre-et-Marie-Curie-Paris, 184, rue du Faubourg-Saint-Antoine, 75012 Paris cedex, France.
出版信息
Rev Med Interne. 2010 Jun;31(6):445-8. doi: 10.1016/j.revmed.2009.11.010. Epub 2010 Apr 14.
INTRODUCTION
Chronic meningococcemia is an unusual clinical presentation within the spectrum of infections due to Neisseria meningitidis.
CASE REPORT
We report a 32-year-old man who presented with a 15-day history of fever and maculopapular skin rash, in the absence of meningeal irritation or severe sepsis manifestation. Blood culture identified N. meningitidis. Clinical course was uneventful after antibiotic treatment was initiated.
CONCLUSION
Early diagnosis of chronic meningococcemia is crucial for optimal management of the patient and his/her contacts. Such a diagnosis should be suspected in the presence of the characteristic clinical triad (recurrent fever, skin rash and arthralgia), and this clinical presentation should be distinguished from systemic vasculitis as inadequate prescription of corticosteroids may be deleterious.
引言
慢性脑膜炎球菌血症是脑膜炎奈瑟菌感染范围内一种不常见的临床表现。
病例报告
我们报告一名32岁男性，有15天发热和斑丘疹性皮疹病史，无脑膜刺激征或严重脓毒症表现。血培养鉴定出脑膜炎奈瑟菌。开始抗生素治疗后临床过程平稳。
结论
慢性脑膜炎球菌血症的早期诊断对于患者及其接触者的最佳管理至关重要。存在特征性临床三联征（反复发热、皮疹和关节痛）时应怀疑此诊断，且这种临床表现应与系统性血管炎相鉴别，因为不适当使用皮质类固醇可能有害。
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