Présentations atypiques d'infections a Neisseria meningitidis. À propos de trois observations

Abstract

Clinical cases – We report three cases of rare or atypical presentations of meningococcal disease. The first concerns urethritis in a 20-year-old man, with no specific clinical presentation. The outcome was favorable after doxycyclin treatment. The second case is an asymptomatic meningococcemia in a five-year-old child, diagnosed by blood culture because there was only one fever episode, and treated with amoxicillin. The last case concerns an early myopericarditis in a 22-year-old man with meningococcal meningitis, with favorable outcome after antibiotherapy and anti-inflammatory treatment. Comments – These case reports show the variable N. meningitidis affinity. Clinical symptoms and treatment of meningococcal urethritis are not specific. Asymptomatic meningococcemia is difficult to recognize. The possible adverse outcome justifies a systematic antibiotherapy. Early myopericarditis is rarely reported. The outcome is favorable following antibiotic and anti-inflammatory treatment, and sometimes pericardiocentesis.