Acute abdomen as an atypical presentation of meningococcal septicaemia.
The clinical manifestations and course of meningococcal disease have been well described, but atypical presentations may, if unrecognized, lead to a delay in treatment. We describe here an unusual case of this disease in a 21-y-old woman who presented with an acute rigid abdomen, clinical and laboratory features of sepsis, shock and early DIC with no indication of meningococcal infection. She developed a rapidly spreading purpuric rash, conjunctival haemorrhages, hypotension and tachycardia and a low urine output. Laboratory investigations showed a low platelet count, low haemoglobin and normal WBC. A presumptive diagnosis of meningococcal septicaemia was made and recovery followed treatment with cefotaxime, fluids and inotropes. A fully sensitive Neisseria meningitis Group C, type 2a, subtype NT was isolated from blood cultures, but not from CSF obtained after antibiotic treatment.
Schmid
M L
ML
Department of Adult and Paediatric Infectious Diseases, Seacroft Hospital, Leeds, UK.
D000006:Abdomen, Acute / Q000209:etiology*; D000328:Adult; D016470:Bacteremia / Q000150:complications*; D005260:Female; D006801:Humans; D008589:Meningococcal Infections / Q000150:complications*