title: Chronic meningococcal disease.
abstract: Chronic meningococcal septicaemia is an unusual and infrequently recognised presentation of disease caused by Neisseria meningitidis. Clinical features are immunologically mediated and include fever, rash and arthritis, which may mimic cutaneous vasculitis or reactive gonococcal arthritis. Diagnosis is difficult to confirm as blood cultures commonly do not grow the organism despite weeks of symptoms. Culture of the organism from the nasopharynx may provide supportive evidence for diagnosis. Chronic meningococcaemia should be considered in the differential diagnosis of a cutaneous vasculitis. In the clinical setting of an undiagnosed fever with vasculitic rash and joint symptoms an empirical trial of intravenously administered penicillin should be considered before steroid therapy as a rapid response may simplify the diagnostic dilemma.
authors.affiliation: Fairfield Infectious Diseases Hospital, Vic.
authors.forename: I D
authors.initials: ID
authors.lastname: Jennens
authors.forename: M
authors.initials: M
authors.lastname: O'Reilley
authors.forename: A P
authors.initials: AP
authors.lastname: Yung
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000175:diagnosis / Q000209:etiology; D002908:Chronic Disease; D003951:Diagnostic Errors; D005260:Female; D006069:Gonorrhea / Q000150:complications; D006801:Humans; D008589:Meningococcal Infections / Q000175:diagnosis* / Q000188:drug therapy; D009305:Nasopharynx / Q000382:microbiology; D009345:Neisseria meningitidis / Q000302:isolation & purification; D010406:Penicillins / Q000627:therapeutic use; D018805:Sepsis / Q000175:diagnosis*; D014657:Vasculitis / Q000175:diagnosis
chemical_list: D000900:Anti-Bacterial Agents; D010406:Penicillins