title: Primary meningococcal septic arthritis of the ankle joint: a case report.
abstract: We present the case of a healthy 18-year-old female who presented with history of an acute onset, painful, swollen right ankle joint. Microbiologic samples from the ankle aspirate grew Neisseria meningitidis. She had had no previous contact with a patient with meningitis nor any existing or preceding clinical symptoms of meningitis. She was treated with surgical drainage with mini-open arthrotomy and a repeat washout at 48 hours. The identification of the organism was expedited using the Analytical Profiling Index (bioMérieux UK, Basingstoke, UK). Our patient was treated with 2 weeks of third-generation cephalosporin antibiotics. At the final follow-up visit, the inflammatory markers had returned to normal, with a normal ankle joint and no evidence of long-term sequelae of septic arthritis. Primary septic arthritis with N. meningitidis is exceptionally rare in the adult population and has been most often reported in the knee. To the best of our knowledge, this is the first reported case of primary septic arthritis of the native adult ankle joint in a healthy individual due to N. meningitides that was diagnosed and treated appropriately with no residual sequelae of the disease.
authors.affiliation: Specialist Registrar, Trauma and Orthopaedics, Western Sussex Hospitals National Health Service Foundation Trust, St. Richards Hospital, Chichester, West Sussex, United Kingdom. Electronic address: christopher.gee@wsht.nhs.uk.
authors.forename: Christopher
authors.initials: C
authors.lastname: Gee
authors.affiliation: Specialist Registrar, Trauma and Orthopaedics, Western Sussex Hospitals National Health Service Foundation Trust, St. Richards Hospital, Chichester, West Sussex, United Kingdom.
authors.forename: Tarang
authors.initials: T
authors.lastname: Tandon
authors.affiliation: Specialist Registrar, Trauma and Orthopaedics, Western Sussex Hospitals National Health Service Foundation Trust, St. Richards Hospital, Chichester, West Sussex, United Kingdom.
authors.forename: Adish
authors.initials: A
authors.lastname: Avasthi
authors.affiliation: Consultant Microbiologist, Western Sussex Hospitals National Health Service Foundation Trust, St. Richards Hospital, Chichester, West Sussex, United Kingdom.
authors.forename: Susie
authors.initials: S
authors.lastname: Jerwood
authors.affiliation: Consultant, Trauma and Orthopaedics, Western Sussex Hospitals National Health Service Foundation Trust, St. Richards Hospital, Chichester, West Sussex, United Kingdom.
authors.forename: Biyyam M
authors.initials: BM
authors.lastname: Rao
authors.affiliation: Consultant, Trauma and Orthopaedics, Western Sussex Hospitals National Health Service Foundation Trust, St. Richards Hospital, Chichester, West Sussex, United Kingdom.
authors.forename: Simon
authors.initials: S
authors.lastname: Cavanagh
mesh_terms: D000293:Adolescent; D000843:Ankle Joint / Q000382:microbiology*; D001170:Arthritis, Infectious / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008589:Meningococcal Infections / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D009345:Neisseria meningitidis / Q000302:isolation & purification*
keywords: Analytic Profiling Index; Meninogococcus; Neisseria; antibiotic; arthrotomy; cephalosporin; polymerase chain reaction