Lachant Daniel, Trawick David
Division of Pulmonary and Critical Care Medicine, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14624, USA.
Case Rep Crit Care. 2015;2015:953826. doi: 10.1155/2015/953826. Epub 2015 Nov 11.
Neisseria meningitidis is an encapsulated gram negative diplococcus that colonizes the nasopharynx and is transmitted by aerosol or secretions with the majority of cases occurring in infants and adolescents. Meningococcemia carries a high mortality which is in part due to myocarditis. Early recognition and prompt use of antibiotics improve morbidity and mortality. We report a 55-year-old male presenting to the emergency department with chest pain, shortness of breath, and electrocardiogram changes suggestive of ST elevation MI who developed cardiogenic shock and multisystem organ failure from N. meningitidis. We present this case to highlight the unique presentation of meningococcemia, the association with myocardial dysfunction, and the importance of early recognition and prompt use of antibiotics.
脑膜炎奈瑟菌是一种有荚膜的革兰氏阴性双球菌,它定殖于鼻咽部,通过气溶胶或分泌物传播,大多数病例发生在婴儿和青少年中。暴发性脑膜炎球菌血症死亡率很高,部分原因是心肌炎。早期识别并及时使用抗生素可改善发病率和死亡率。我们报告一例55岁男性,因胸痛、呼吸急促和提示ST段抬高型心肌梗死的心电图改变就诊于急诊科,该患者因脑膜炎奈瑟菌感染发展为心源性休克和多系统器官功能衰竭。我们展示此病例以突出暴发性脑膜炎球菌血症的独特表现、与心肌功能障碍的关联以及早期识别和及时使用抗生素的重要性。