1887

Abstract

Introduction:

is the leading cause of bacterial meningitis in children and young adults. Multiple complications have been reported previously, either at the time of presentation or later during the recovery phase of the illness. Cardiac arrhythmias and electrocardiogram (ECG) abnormalities have rarely been reported in infection.

Case presentation:

We report a 48-year-old African-American man, with newly diagnosed human immunodeficiency virus infection, admitted with a diagnosis of meningococcal meningitis. An initial 12-lead ECG at admission showed a normal sinus rhythm with widespread concave ST elevation. The patient's troponin level was significantly elevated. A Transthoracic echocardiogram revealed left ventricle moderate anterior pericardial effusion. He was treated with antibiotics for meningitis and ibuprofen for myopericarditis. He subsequently developed atrial fibrillation, which was suppressed with metoprolol, diltiazem and amiodarone during hospitalization. To the best of our knowledge, this is the first reported case of atrial fibrillation complicating meningococcal meningitis.

Conclusion:

Myopericarditis complicates the course of meningococcal meningitis. Various forms of cardiac arrhythmias can occur during the course of meningococcal infection. Therefore, telemetry and serial ECG monitoring are recommended throughout the course of meningococcal infection.

  • This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0/).
Loading

Article metrics loading...

/content/journal/jmmcr/10.1099/jmmcr.0.000062
2015-06-01
2024-10-14
Loading full text...

Full text loading...

/deliver/fulltext/jmmcr/2/3/jmmcr000062.html?itemId=/content/journal/jmmcr/10.1099/jmmcr.0.000062&mimeType=html&fmt=ahah

References

  1. Abio A, Neal K.R, Beck C.R. 2013; An epidemiological review of changes in meningococcal biology during the last 100 years. Pathog Glob Health 107:373–380 [CrossRef]
    [Google Scholar]
  2. Cohen C, Singh E, Wu H.M, Martin S, de Gouveia L, Klugman K.P, Meiring S, Govender N, von Gottberg A, (GERMS-SA) Group for Enteric, Respiratory and Meningeal disease Surveillance in South Africa. 2010; Increased incidence of meningococcal disease in HIV-infected individuals associated with higher case-fatality ratios in South Africa. AIDS 24:1351–1360 [CrossRef]
    [Google Scholar]
  3. Cohn A.C, MacNeil J.R, Clark T.A, Ortega-Sanchez I.R, Briere E.Z, Meissner H.C, Baker C.J, Messonnier N.E. 2013; Prevention and control of meningococcal disease: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 62:RR-21–22
    [Google Scholar]
  4. Detsky A.S, Salit I.E. 1983; Complete heart block in meningococcemia. Ann Emerg Med 12:391–393 [CrossRef]
    [Google Scholar]
  5. Durand M.L, Calderwood S.B, Weber D.J, Miller S.I, Southwick F.S, Caviness V.S Jr, Swartz M.N. 1993; Acute bacterial meningitis in adults. A review of 493 episodes. N Engl J Med 328:21–28 [CrossRef]
    [Google Scholar]
  6. Edmond K, Clark A, Korczak V.S, Sanderson C, Griffiths U.K, Rudan I. 2010; Global and regional risk of disabling sequelae from bacterial meningitis: a systematic review and meta-analysis. Lancet Infect Dis 10:317–328 [CrossRef]
    [Google Scholar]
  7. Etherington J, Salmon J, Ratcliffe G. 1995; Atrio-ventricular dissociation in meningococcal meningitis. J R Army Med Corps 141:169–171 [CrossRef]
    [Google Scholar]
  8. Fuglsang Hansen J, Johansen I.S. 2013; [Immune-mediated pericarditis in a patient with meningococcal meningitis]. Ugeskr Laeger 175:967–968 (in Danish)
    [Google Scholar]
  9. Gach O, Lancellotti P, Pierard L.A. 2001; Acute ST-segment elevation in Neisseria meningitis. Acta Cardiol 56:327–329 [CrossRef]
    [Google Scholar]
  10. Hardman J.M, Earle K.M. 1969; Myocarditis in 200 fatal meningococcal infections. Arch Pathol 87:318–325
    [Google Scholar]
  11. Morgan D.R, Spence M, Crowe M, O'Keeffe D.B. 2002; Primary (isolated) meningococcal pericarditis. Clin Cardiol 25:305–307 [CrossRef]
    [Google Scholar]
  12. Saslaw S, Diserens R.V. 1960; Purulent pericardial effusion complicating meningococcal meningitis. N Engl J Med 263:1074–1075 [CrossRef]
    [Google Scholar]
  13. Shapira M.Y, Hirshberg B, Ben-Yehuda A. 1997; Asymptomatic temporary atrioventricular dissociation complicating meningococcal meningitis. Int J Cardiol 62:277–278 [CrossRef]
    [Google Scholar]
  14. Simon M.S, Weiss D, Gulick R.M. 2013; Invasive meningococcal disease in men who have sex with men. Ann Intern Med 159:300–301 [CrossRef]
    [Google Scholar]
  15. Wansbrough-Jones M.H, Wong O.P. 1973; Meningococcal pericarditis without meningitis. Br Med J 2:344–345 [CrossRef]
    [Google Scholar]
  16. Zeidan A, Tariq S, Faltas B, Urban M, McGrody K. 2008; A case of primary meningococcal pericarditis caused by Neisseria meningitidis serotype Y with rapid evolution into cardiac tamponade. J Gen Intern Med 23:1532–1535 [CrossRef]
    [Google Scholar]
/content/journal/jmmcr/10.1099/jmmcr.0.000062
Loading
/content/journal/jmmcr/10.1099/jmmcr.0.000062
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error