title: Non-Q wave acute myocardial infarction in acute meningococcemia in a 10-year-old girl.
abstract: BACKGROUND
  Children with acute meningococcemia may have impaired myocardial function resulting in low cardiac output despite normal intravascular volume. Severe meningococcal infection has been associated with acute interstitial myocarditis, endocarditis, and pericarditis, but not with myocardial infarction.
  
  
  METHODS
  We present the case of a 10-year-old girl with positive family history for premature myocardial infarction who sustained an acute myocardial infarction temporally related to meningococcemia.
  
  
  CONCLUSIONS
  This is the first pediatric case of non-Q wave acute myocardial infarction associated with purpura fulminans in meningococcemia. Similarly, the association of high troponin I levels and meningococcemia has not been described previously. Although, the patient's genetic predisposition for myocardial infarction might have been a potential contributing factor, there was no angiographic evidence of coronary artery disease in this patient. Thereby, other factors related to shock, endotoxin, microthrombi of meningococcemia, and their treatment might have been also contributing. We propose possible mechanisms for this rare but serious complication of meningococcemia and review the literature.
authors.affiliation: Pediatric Intensive Care Unit, Aghia Sophia Children's Hospital, Athens, Greece. Briassg@otenet.gr
authors.forename: G
authors.initials: G
authors.lastname: Briassoulis
authors.forename: P
authors.initials: P
authors.lastname: Kalabalikis
authors.forename: V
authors.initials: V
authors.lastname: Thanopoulos
authors.forename: T
authors.initials: T
authors.lastname: Hatzis
mesh_terms: D000208:Acute Disease; D016470:Bacteremia / Q000150:complications* / Q000382:microbiology; D002648:Child; D004562:Electrocardiography; D005260:Female; D006801:Humans; D011695:IgA Vasculitis / Q000209:etiology; D008589:Meningococcal Infections / Q000097:blood / Q000150:complications*; D009203:Myocardial Infarction / Q000097:blood / Q000235:genetics / Q000382:microbiology* / Q000503:physiopathology; D019210:Troponin I / Q000097:blood
chemical_list: D019210:Troponin I