Meningococcemia as an initial manifestation of systemic lupus erythematosus: Report of a case and review of the literature

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2017

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Australasian Medical Journal, 1836-1935, Vol. 10, Nro. 12, 2017, p. 1036-1041

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The Australasian Medical Journal

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Abstract

Systemic lupus erythematosus (SLE) is an inflammatory disease with a wide range of clinical manifestations and complications related to disease activity. One of them is the increase risk to infections secondary to immunological alterations due to pharmacological therapy (especially steroids). Few reports have documented the association of SLE and meningococcal infection with subsequent development of immunological activation (continuous inflammation) and intolerance of the immune system. The attempts to make an early and appropriate approach to these type of patients, generate benefits in survival rates and decrease sequelae among those who survive, especially in those in whose infection compromised central nervous system. We present the case of a patient that presented with neurological symptoms compatible with neuroeffector by Neisseria meningitis isolated in CSF cultures. Despite adequate antibiotic treatment the patient continued to deteriorate neurologically, and alternative diagnosis were evaluated after findings of vasculitis in brain CT scan. Immunological panel was performed with positivity of antibodies commonly present in SLE considering that infection by Neisseria meningitis was a trigger of immunological intolerance and development of SLE. We present the following case to understand the physiopathology and relationship between meningococcal infections, complement consumption, immunological intolerance and the development of autoimmune disease.

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Keywords

Meningococcal sepsis, Systemic lupus erythematosus, Mortality

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