Infectious Diseases Department, Centro Hospitalar Universitário de São João, Alameda Professor Hernani Monteiro, 4200-319, Porto, Portugal; Faculty of Medicine, University of Porto, Porto, Portugal; Instituto de Inovação e Investigação em Saúde (I3s), Grupo de I&D em Nefrologia e Doenças Infeciosas, Department of Medicine, Faculty of Medicine, University of Porto, Porto, Portugal; Corresponding author at: Infectious Diseases Department, Centro Hospitalar Universitário de São João, Alameda Professor Hernani Monteiro, 4200-319, Porto, Portugal.
Francisco Almeida
Infectious Diseases Department, Centro Hospitalar Universitário de São João, Alameda Professor Hernani Monteiro, 4200-319, Porto, Portugal; Faculty of Medicine, University of Porto, Porto, Portugal; Instituto de Inovação e Investigação em Saúde (I3s), Grupo de I&D em Nefrologia e Doenças Infeciosas, Department of Medicine, Faculty of Medicine, University of Porto, Porto, Portugal
Ana Cláudia Carvalho
Infectious Diseases Department, Centro Hospitalar Universitário de São João, Alameda Professor Hernani Monteiro, 4200-319, Porto, Portugal; Faculty of Medicine, University of Porto, Porto, Portugal; Instituto de Inovação e Investigação em Saúde (I3s), Grupo de I&D em Nefrologia e Doenças Infeciosas, Department of Medicine, Faculty of Medicine, University of Porto, Porto, Portugal
Susana Silva
Infectious Diseases Department, Centro Hospitalar Universitário de São João, Alameda Professor Hernani Monteiro, 4200-319, Porto, Portugal; Faculty of Medicine, University of Porto, Porto, Portugal; Instituto de Inovação e Investigação em Saúde (I3s), Grupo de I&D em Nefrologia e Doenças Infeciosas, Department of Medicine, Faculty of Medicine, University of Porto, Porto, Portugal
António Sarmento
Infectious Diseases Department, Centro Hospitalar Universitário de São João, Alameda Professor Hernani Monteiro, 4200-319, Porto, Portugal; Faculty of Medicine, University of Porto, Porto, Portugal; Instituto de Inovação e Investigação em Saúde (I3s), Grupo de I&D em Nefrologia e Doenças Infeciosas, Department of Medicine, Faculty of Medicine, University of Porto, Porto, Portugal
The spectrum of Neisseria meningitidis-associated clinical entities involves mild forms of disease, without neurological involvement or sepsis, and asymptomatic carrier states. Rarely, N. meningitidis bacteremia can be associated with a prolonged fever with or without arthritis, which we designate as chronic meningococcemia. Chronic meningococcemia is an uncommon entity, usually associated to serogroup B N. meningitidis. Diagnosis is frequently delayed as blood cultures collected outside febrile periods can be negative. We present a case of chronic meningococcemia in a 22-year-old woman with no relevant clinical background, presenting with fever, arthralgia and exanthem. Due to the potential for progression to more severe disease and the risk of N. meningitidis transmission and development of secondary cases, a high degree of clinical suspicion is required to ensure prompt recognition and adequate treatment. Our patient had a favorable outcome probably due to early recognition and adequate treatment, which is critical for the resolution of the disease without complications. Keywords: Chronic meningococcemia, Mild meningococcal disease, Meningococcal rash and arthritis, Arthritis-dermatitis syndrome
