Acute meningococcaemia complicated by late onset gastrointestinal vasculitis.

Abstract

Extra-meningeal and non-cutaneous manifestations of meningococcal infection are well recognized but rare. Herein we report a little recognized complication of meningococcaemia, namely late-onset gastrointestinal vasculitis. In the case presented, the prostacycline analogue iloprost was used in an attempt to minimize incipient digital gangrene ina patient with evidence of protracted immunological phenomena. In addition, diclofenac was used to treat severe arthralgia. Withdrawal of iloprost on day 19 was associated with abdominal pain and peritonism. Laparotomy demonstrated ischaemia and ulceration in the caecum, and histology revealed full thickness mucosal ulceration with a prominent vasculitic process. It is postulated that these findings were immunologically mediated, with possible rebound vasoconstriction following withdrawal of iloprost. It is also possible that NSAID use contributed to the findings via cyto-toxicity to mucosal cells.

• Authors: R A Seaton, D Nathwani, J Dick, D Smith
• Journal: The Journal of infection (J Infect) Vol. 41 Issue 2 Pg. 190-1 (Sep 2000) ISSN: 0163-4453 [Print] England
• PMID: 11023771 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright 2000 The British Infection Society.

Chemical References

• Anti-Inflammatory Agents, Non-Steroidal
• Platelet Aggregation Inhibitors
• Vasodilator Agents
• Iloprost

Topics

• Adolescent
• Anti-Inflammatory Agents, Non-Steroidal (adverse effects)
• Bacteremia (complications)
• Gastrointestinal Diseases (etiology)
• Humans
• Iloprost (adverse effects)
• Male
• Meningococcal Infections (complications)
• Neisseria meningitidis (isolation & purification)
• Platelet Aggregation Inhibitors (adverse effects, therapeutic use)
• Time Factors
• Vasculitis (etiology)
• Vasodilator Agents (adverse effects)