Meningococcal meningitis complicated by septic shock, myocarditis and purpura fulminans

Meningococcal disease is a rapidly progressive, life-threatening infection caused by Neisseria meningitidis. Typical presentations include meningitis, septicaemia, or a combination of the two. Rarely, it can be complicated by purpura fulminans and myocarditis, contributing to increased morbidity an...

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Main Authors: H. M. U. A. S. Perera, N. M. Perera, S. A. P. K. Siriwardhana
Format: Article
Language:English
Published: Sri Lanka College of Internal Medicine 2025-08-01
Series:Asian Journal of Internal Medicine
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Online Access:https://account.ajim.sljol.info/index.php/sljo-j-ajim/article/view/305
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author H. M. U. A. S. Perera
N. M. Perera
S. A. P. K. Siriwardhana
author_facet H. M. U. A. S. Perera
N. M. Perera
S. A. P. K. Siriwardhana
author_sort H. M. U. A. S. Perera
collection DOAJ
description Meningococcal disease is a rapidly progressive, life-threatening infection caused by Neisseria meningitidis. Typical presentations include meningitis, septicaemia, or a combination of the two. Rarely, it can be complicated by purpura fulminans and myocarditis, contributing to increased morbidity and mortality. We report a case of a previously healthy 16-year-old boy presenting with a 3-day history of fever, headache and altered consciousness. He was hypotensive, febrile and tachycardic on admission, with a purpuric skin rash suggestive of purpura fulminans and neck stiffness. Investigations revealed leukocytosis, thrombocytopenia, elevated inflammatory markers, and cerebrospinal fluid analysis consistent with bacterial meningitis. PCR confirmed Neisseria meningitidis. Elevated troponin I and echocardiography indicated myocarditis. He was treated in the ICU with fluids, inotropes and intravenous ceftriaxone. The patient made a full recovery, with normalisation of cardiac function and inflammatory markers. This case underscores the severe and aggressive nature of meningococcal disease, emphasising the importance of early recognition and timely multidisciplinary intervention in preventing poor outcomes in healthy individuals.
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institution Kabale University
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publisher Sri Lanka College of Internal Medicine
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series Asian Journal of Internal Medicine
spelling doaj-art-5fcd8ded58be456c9de2ad3c08fedb462025-08-20T04:01:23ZengSri Lanka College of Internal MedicineAsian Journal of Internal Medicine2827-72602025-08-014210.4038/ajim.v4i2.305Meningococcal meningitis complicated by septic shock, myocarditis and purpura fulminansH. M. U. A. S. Perera0N. M. Perera1S. A. P. K. Siriwardhana2Colombo North Teaching Hospital, RagamaColombo North Teaching Hospital, RagamaColombo North Teaching Hospital, Ragama Meningococcal disease is a rapidly progressive, life-threatening infection caused by Neisseria meningitidis. Typical presentations include meningitis, septicaemia, or a combination of the two. Rarely, it can be complicated by purpura fulminans and myocarditis, contributing to increased morbidity and mortality. We report a case of a previously healthy 16-year-old boy presenting with a 3-day history of fever, headache and altered consciousness. He was hypotensive, febrile and tachycardic on admission, with a purpuric skin rash suggestive of purpura fulminans and neck stiffness. Investigations revealed leukocytosis, thrombocytopenia, elevated inflammatory markers, and cerebrospinal fluid analysis consistent with bacterial meningitis. PCR confirmed Neisseria meningitidis. Elevated troponin I and echocardiography indicated myocarditis. He was treated in the ICU with fluids, inotropes and intravenous ceftriaxone. The patient made a full recovery, with normalisation of cardiac function and inflammatory markers. This case underscores the severe and aggressive nature of meningococcal disease, emphasising the importance of early recognition and timely multidisciplinary intervention in preventing poor outcomes in healthy individuals. https://account.ajim.sljol.info/index.php/sljo-j-ajim/article/view/305Neisseria meningitidisMeningococcal meningitisPurpura fulminansMyocarditis
spellingShingle H. M. U. A. S. Perera
N. M. Perera
S. A. P. K. Siriwardhana
Meningococcal meningitis complicated by septic shock, myocarditis and purpura fulminans
Asian Journal of Internal Medicine
Neisseria meningitidis
Meningococcal meningitis
Purpura fulminans
Myocarditis
title Meningococcal meningitis complicated by septic shock, myocarditis and purpura fulminans
title_full Meningococcal meningitis complicated by septic shock, myocarditis and purpura fulminans
title_fullStr Meningococcal meningitis complicated by septic shock, myocarditis and purpura fulminans
title_full_unstemmed Meningococcal meningitis complicated by septic shock, myocarditis and purpura fulminans
title_short Meningococcal meningitis complicated by septic shock, myocarditis and purpura fulminans
title_sort meningococcal meningitis complicated by septic shock myocarditis and purpura fulminans
topic Neisseria meningitidis
Meningococcal meningitis
Purpura fulminans
Myocarditis
url https://account.ajim.sljol.info/index.php/sljo-j-ajim/article/view/305
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AT nmperera meningococcalmeningitiscomplicatedbysepticshockmyocarditisandpurpurafulminans
AT sapksiriwardhana meningococcalmeningitiscomplicatedbysepticshockmyocarditisandpurpurafulminans