Fox-Lewis A, Eades C P, Manson J J, Morris-Jones S, Miller R F
1 T8 Ward, University College London Hospitals NHS Foundation Trust, London, UK.
2 Mortimer Market Centre, Central and North West London NHS Foundation Trust, London, UK.
Int J STD AIDS. 2017 Aug;28(9):943-946. doi: 10.1177/0956462417691439. Epub 2017 Jan 25.
A patient with well-controlled HIV-1 infection presented with fever and rigors, a widespread maculopapular rash, and severe generalised arthralgia. Sepsis of unknown aetiology was diagnosed, and treatment with broad-spectrum antimicrobials commenced. Following initial clinical improvement, a right knee septic arthritis developed. Microscopy and culture of the joint aspirate were negative for organisms but 16S rDNA PCR identified Neisseria meningitidis DNA, subsequently verified as capsular genogroup C, thus confirming a diagnosis of disseminated meningococcal sepsis with secondary septic arthritis.
一名HIV-1感染控制良好的患者出现发热、寒战、广泛的斑丘疹和严重的全身性关节痛。诊断为病因不明的脓毒症，并开始使用广谱抗菌药物治疗。在最初的临床症状改善后，右侧膝关节发生了化脓性关节炎。关节穿刺液的显微镜检查和培养未发现微生物，但16S rDNA聚合酶链反应鉴定出脑膜炎奈瑟菌DNA，随后证实为C群荚膜型，从而确诊为播散性脑膜炎球菌脓毒症伴继发性化脓性关节炎。
