[ Monoarthrite primitive isolée du genou à Neisseria meningitidis du groupe B: A propos d’un cas ]
Volume 25, Issue 4, March 2019, Pages 1297–1301
Kaoutar OUAZZANI TOUHAMI1, Jihane CHIGUER2, Fakhreddine MAALOUM3, Khalid ZEROUALI4, and Houria BELABBES5
1 Laboratoire de Bactériologie, Virologie et Hygiène Hospitalière, Centre Hospitalier Universitaire Ibn Rochd, Casablanca, Maroc
2 Laboratoire de Bactériologie, Virologie et Hygiène Hospitalière, Centre Hospitalier Universitaire Ibn Rochd, Casablanca, Maroc
3 Laboratoire de Bactériologie, Virologie et Hygiène Hospitalière, Centre Hospitalier Universitaire Ibn Rochd, Casablanca, Maroc
4 Laboratoire de Bactériologie, Virologie et Hygiène Hospitalière, Centre Hospitalier Universitaire Ibn Rochd, Casablanca, Maroc
5 Laboratoire de Bactériologie, Virologie et Hygiène Hospitalière, Centre Hospitalier Universitaire Ibn Rochd, Casablanca, Maroc
Original language: French
Copyright © 2019 ISSR Journals. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
INTRODUCTION: Primary arthritis is a rare form of meningococccal disease. It occurs as an isolated acute purulent arthritis without meningitis, and presence of Neisseria meningitidis in articular fluid. PATIENT AND OBSERVATION: We report the case of an infant aged 45 days without any particular medical history presenting isolated primitive monoarthritis of the left knee to Neisseria meningitidis group B unhurt of meningeal infringement, at Children's Abderrahim El Harouchi hospital of Casablanca. The examination in the admission showed a feverish infant, with presence of a painful and inflammatory effusion of the left knee. The neurological examination was normal and did not reveal signs of meningeal infringement. The articular draining resembled a purulent liquid whose cytobacteriogical examination showed the presence of neutrophils in heap, the culture revealed the presence of Neisseria meningitidis. The serogroup allowed to show that it was about the serogroup B. This result was confirmed by molecular biology (PCR). The study of the sensitivity in antibiotics by E-test revealed an origin sensitive to the penicillin G and to the 3rd-generation cephalosporin. An evacuation of the articular effusion was performed and an antibiotic treatment with ampicillin-sulbactam and of gentamicin was administred, allowing a favorable evolution within a few days. CONCLUSIONS: The diagnosis of primitive arthritis with meningococcus without meningeal infringement is infrequent, but probably underestimated because of the rarity of the practice of the articular punctions and the blood cultures in front of these situations. The diagnosis and the early treatment of this pathology allow a cure without long term-side effects.
Author Keywords: Monoarthritis of knee, gonococcal arthritis without meningitis, Neisseria meningitidis, diagnosis.
Volume 25, Issue 4, March 2019, Pages 1297–1301
Kaoutar OUAZZANI TOUHAMI1, Jihane CHIGUER2, Fakhreddine MAALOUM3, Khalid ZEROUALI4, and Houria BELABBES5
1 Laboratoire de Bactériologie, Virologie et Hygiène Hospitalière, Centre Hospitalier Universitaire Ibn Rochd, Casablanca, Maroc
2 Laboratoire de Bactériologie, Virologie et Hygiène Hospitalière, Centre Hospitalier Universitaire Ibn Rochd, Casablanca, Maroc
3 Laboratoire de Bactériologie, Virologie et Hygiène Hospitalière, Centre Hospitalier Universitaire Ibn Rochd, Casablanca, Maroc
4 Laboratoire de Bactériologie, Virologie et Hygiène Hospitalière, Centre Hospitalier Universitaire Ibn Rochd, Casablanca, Maroc
5 Laboratoire de Bactériologie, Virologie et Hygiène Hospitalière, Centre Hospitalier Universitaire Ibn Rochd, Casablanca, Maroc
Original language: French
Copyright © 2019 ISSR Journals. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
INTRODUCTION: Primary arthritis is a rare form of meningococccal disease. It occurs as an isolated acute purulent arthritis without meningitis, and presence of Neisseria meningitidis in articular fluid. PATIENT AND OBSERVATION: We report the case of an infant aged 45 days without any particular medical history presenting isolated primitive monoarthritis of the left knee to Neisseria meningitidis group B unhurt of meningeal infringement, at Children's Abderrahim El Harouchi hospital of Casablanca. The examination in the admission showed a feverish infant, with presence of a painful and inflammatory effusion of the left knee. The neurological examination was normal and did not reveal signs of meningeal infringement. The articular draining resembled a purulent liquid whose cytobacteriogical examination showed the presence of neutrophils in heap, the culture revealed the presence of Neisseria meningitidis. The serogroup allowed to show that it was about the serogroup B. This result was confirmed by molecular biology (PCR). The study of the sensitivity in antibiotics by E-test revealed an origin sensitive to the penicillin G and to the 3rd-generation cephalosporin. An evacuation of the articular effusion was performed and an antibiotic treatment with ampicillin-sulbactam and of gentamicin was administred, allowing a favorable evolution within a few days. CONCLUSIONS: The diagnosis of primitive arthritis with meningococcus without meningeal infringement is infrequent, but probably underestimated because of the rarity of the practice of the articular punctions and the blood cultures in front of these situations. The diagnosis and the early treatment of this pathology allow a cure without long term-side effects.
Author Keywords: Monoarthritis of knee, gonococcal arthritis without meningitis, Neisseria meningitidis, diagnosis.
Abstract: (french)
INTRODUCTION: L'arthrite primitive à Neisseria meningitidis est une manifestation rare. Il s'agit d'une mono-ou polyarthrite purulente isolée, sans atteinte méningée, avec présence du germe dans l'articulation. PATIENTS ET OBSERVATION: Nous rapportons le cas d’un nourrisson de sexe féminin âgé de 45 jours sans antécédents particuliers, admis au service de chirurgie infantile présentant une monoarthrite primitive isolée du genou gauche à Neisseria meningitidis du groupe B indemne d’atteinte méningée, à l’Hôpital d’Enfants Abderrahim El Harouchi du Centre Hospitalier Universitaire (CHU) Ibn Rochd de Casablanca. L’examen à l’admission a objectivé un nourrisson fébrile, avec présence d’un épanchement douloureux et inflammatoire du genou gauche. L’examen neurologique était strictement normal et ne révélait pas des signes d’atteinte méningée. La ponction articulaire a ramené un liquide purulent dont l’examen cytobactériologique a montré la présence de polynucléaires neutrophiles en amas (incomptable), la culture a révélé la présence de Neisseria meningitidis. Le sérogroupage a permis de montrer qu’il s’agissait du sérogroupe B. Ce résultat a été confirmé par biologie moléculaire (PCR). L’étude de la sensibilité aux antibiotiques par E-test a révélé une souche sensible à la pénicilline G et aux céphalosporines de 3ème génération. Une évacuation de l’épanchement articulaire et une antibiothérapie à base d’ampicilline-sulbactam et de gentamicine a été instaurée permettant une évolution favorable après quelques jours. CONCLUSION: Le diagnostic d’arthrite primitive à méningocoque sans atteinte méningée est peu fréquent, mais probablement sous-estimé en raison de la rareté de la pratique des pontions articulaires et des hémocultures devant ces situations. Le diagnostic et le traitement précoce de cette pathologie permettent une guérison sans séquelles.
Author Keywords: Monoarthrite du genou, arthrite gonococcique sans méningite, Neisseria meningitidis, diagnostic.
How to Cite this Article
Kaoutar OUAZZANI TOUHAMI, Jihane CHIGUER, Fakhreddine MAALOUM, Khalid ZEROUALI, and Houria BELABBES, “Primary meningococcal arthritis of the knee caused by Neisseria meningitidis group B: About a case,” International Journal of Innovation and Applied Studies, vol. 25, no. 4, pp. 1297–1301, March 2019.
