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Fulminant meningococcemia with meningococcal meningitis in the neonate: a case report

Durgesh Kumar, Rajesh Kumar Yadav, Dinesh Kumar Singh, Indra Kumar Sharma, Krishan Mohan Shukla, Mohammad Avais.

Abstract
Although meningococcal meningitis is fairly common in children, in neonate, it is rare with systemic involvement presumably because of transplacental passage of protective maternal antibodies. The diagnosis depends on a combination of clinical examination, including fever, refusal to feed, convulsions and the typical rash, and pathological and microbiological confirmation of the disease. Outcome of the disease may be fatal if timely intervention not done. In the literature, very few cases of neonatal meningococcal disease have been reported in the India. We are reporting a 14 day old neonate who developed meningococcemia with meningococcal meningitis on the 9th day of life, evolving to septic shock. The blood and the cerebrospinal fluid cultures were positive for Neisseria meningitidis. The meningococcemia should be suspected as a cause of cutaneous petechiae and purpura in neonates having signs of septicemia as early identification and management of meningococcemia with meningitis in the neonate can be life saving.

Key words: Meningococcemia, Meningitis, Neonate, Septicemia, Petechiae



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