Meningococcemia presenting as acute polyarthritis.

Four patientw with acute polyarthritis due to meningcoccemia are described. One had skin manifestations suggesting vasculitis, another had transient nodular lesions, but there were none of these features in the other two. Synovial fluid cultures were negative and cells counts did not suggest septic arthritis. The diagnosis was not suspected until positive blood cultures were reported in three cases and meningitis developed in the fourth. In spite of diagnostic delay due to slow growth in cultures (six to 11 days) there was prompt response to antibiotic treatment. Meningococcemia should be suspected in patients presenting with fever and polyarthritis, even in the absence of skin lesions.