title: Primary meningococcal arthritis as initial presentation in a previously undiagnosed HIV-infected patient.
abstract: A 38-year-old African-American male complaining of pain in multiple joints was initially diagnosed with gouty arthritis concurrent with gonococcal septic arthritis. The diagnosis was made based on arthrocentesis results showing Gram-variable cocci and monosodium urate crystals in the synovial fluid. Final blood and synovial fluid cultures confirmed a diagnosis of primary septic arthritis caused by Neisseria meningitidis, serogroup X. Further evaluation revealed a reactive HIV antibody test with enzyme- linked immunoassay (ELISA) confirmed by western blot. His CD4 count was 36 cells/mm and viral load was >500,000 copies/mL. We present a case of primary meningococcal arthritis caused by N meningitidis serogroup X as the initial presentation of a patient with previously undiagnosed HIV.
authors.affiliation: Department of Clinical Pharmacy and Outcomes Sciences, South Carolina College of Pharmacy, University of South Carolina Campus, Columbia, SC 29208, USA.
authors.forename: P Brandon
authors.initials: PB
authors.lastname: Bookstaver
authors.forename: Celeste N
authors.initials: CN
authors.lastname: Rudisill
mesh_terms: D000328:Adult; D001170:Arthritis, Infectious / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D015153:Blotting, Western; D003937:Diagnosis, Differential; D004797:Enzyme-Linked Immunosorbent Assay; D015658:HIV Infections / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008589:Meningococcal Infections / Q000175:diagnosis* / Q000188:drug therapy