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Arthritis secondary to meningococcal disease: A case series of 7 patients.

Abstract Arthritis secondary to invasive meningococcemia is rare and has been described as a direct result of bacteremia or as immunoallergic-type arthritis, related to the immune complex. Only a few case series have been reported.This multicenter study aimed to describe the clinical characteristics and therapeutic outcomes of arthritis secondary to meningococcal infection.We performed a 5-year retrospective study. We included all patients with inflammatory joint symptoms and proven meningococcal disease defined by the identification of Neisseria meningitidis in blood, cerebrospinal fluid, or synovial fluid. Septic arthritis was defined by the identification of N meningitidis in joint fluid. Immune-mediated arthritis was considered to be arthritis occurring after at least 1 day of invasive meningococcal disease without positive joint fluid culture.A total of 7 patients (5 males) with joint symptoms and meningococcal disease were identified. The clinical presentation was mainly oligoarticular and the knee was the most frequent joint site. Five patients had septic arthritis and 4 had immune-mediated arthritis; 2 had septic arthritis followed by immune-mediated arthritis. Immune-mediated arthritis occurred 3 to 7 days after meningococcal meningitis, and treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) led to improvement without complications.Physicians must be vigilant to the different clinical presentations in patients with arthritis associated with invasive meningococcal disease. If immune-mediated arthritis is suspected, NSAIDs are usually efficient.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 28723791
OWN - NLM
STAT- MEDLINE
DA  - 20170720
DCOM- 20170808
LR  - 20170808
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 29
DP  - 2017 Jul
TI  - Arthritis secondary to meningococcal disease: A case series of 7 patients.
PG  - e7573
LID - 10.1097/MD.0000000000007573 [doi]
AB  - Arthritis secondary to invasive meningococcemia is rare and has been described as
      a direct result of bacteremia or as immunoallergic-type arthritis, related to the
      immune complex. Only a few case series have been reported.This multicenter study 
      aimed to describe the clinical characteristics and therapeutic outcomes of
      arthritis secondary to meningococcal infection.We performed a 5-year
      retrospective study. We included all patients with inflammatory joint symptoms
      and proven meningococcal disease defined by the identification of Neisseria
      meningitidis in blood, cerebrospinal fluid, or synovial fluid. Septic arthritis
      was defined by the identification of N meningitidis in joint fluid.
      Immune-mediated arthritis was considered to be arthritis occurring after at least
      1 day of invasive meningococcal disease without positive joint fluid culture.A
      total of 7 patients (5 males) with joint symptoms and meningococcal disease were 
      identified. The clinical presentation was mainly oligoarticular and the knee was 
      the most frequent joint site. Five patients had septic arthritis and 4 had
      immune-mediated arthritis; 2 had septic arthritis followed by immune-mediated
      arthritis. Immune-mediated arthritis occurred 3 to 7 days after meningococcal
      meningitis, and treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) led 
      to improvement without complications.Physicians must be vigilant to the different
      clinical presentations in patients with arthritis associated with invasive
      meningococcal disease. If immune-mediated arthritis is suspected, NSAIDs are
      usually efficient.
FAU - Masson-Behar, Vanina
AU  - Masson-Behar V
AD  - aUniversite Paris Diderot, Sorbonne Paris Cite, UFR de Medecine bAP-HP, Service
      de Rhumatologie, Hopital Bichat cUniversite Paris Diderot, Sorbonne Paris Cite,
      UFR de Medecine dAP-HP, Service de Bacteriologie-Virologie, Hopital Lariboisiere 
      eUniversite Paris Diderot, Sorbonne Paris Cite, UFR de Medecine fAP-HP, Service
      de Rhumatologie, Hopital Lariboisiere gService de Rhumatologie et Medecine
      Interne. Centre de Reference des Infections Osteo-articulaire complexes. Groupe
      hospitalier Diaconesses Croix St-Simon hUniversite Paris Diderot, Sorbonne Paris 
      Cite, UFR de Medecine iAP-HP, Service de Maladie infectieuses, Hopital Bichat,
      Paris, France.
FAU - Jacquier, Herve
AU  - Jacquier H
FAU - Richette, Pascal
AU  - Richette P
FAU - Ziza, Jean-Marc
AU  - Ziza JM
FAU - Zeller, Valerie
AU  - Zeller V
FAU - Rioux, Christophe
AU  - Rioux C
FAU - Coustet, Baptiste
AU  - Coustet B
FAU - Dieude, Philippe
AU  - Dieude P
FAU - Ottaviani, Sebastien
AU  - Ottaviani S
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Anti-Inflammatory Agents, Non-Steroidal)
SB  - AIM
SB  - IM
MH  - Adolescent
MH  - Aged
MH  - Aged, 80 and over
MH  - Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
MH  - Arthritis/diagnosis/drug therapy/*etiology/physiopathology
MH  - Diagnosis, Differential
MH  - Female
MH  - France
MH  - Humans
MH  - Knee/diagnostic imaging/pathology
MH  - Male
MH  - Meningococcal Infections/*complications/diagnosis/drug therapy/physiopathology
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Tertiary Care Centers
MH  - Young Adult
PMC - PMC5521931
EDAT- 2017/07/21 06:00
MHDA- 2017/08/09 06:00
CRDT- 2017/07/21 06:00
AID - 10.1097/MD.0000000000007573 [doi]
AID - 00005792-201707210-00056 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Jul;96(29):e7573. doi: 10.1097/MD.0000000000007573.