Neisseria meningitidis presenting as acute abdomen and recurrent reactive pericarditis

ABSTRACT Meningococcal meningitis is a well established potential fatal infection characterized by fever, headache, petechial rash, and vomiting in the majority of cases. However, protean manifestations including abdominal pain, sore throat, diarrhea and cough, even though rare, should not be overlooked. Similarly, although disseminated infection could potentially involve various organ-targets, secondary immune related complications including joints or pericardium should be dealt with caution, since they remain unresponsive to appropriate antibiotic regimens. We hereby report the rare case of an otherwise healthy adult female, presenting with acute abdominal pain masking Neisseria meningitidis serotype B meningitis, later complicated with recurrent reactive pericarditis despite appropriate antibiotic treatment. There follows a review of current literature.

Linfoadenitis criptococócica mesentérica: Una rara causa de abdomen agudo. Caso clínico / Mesenteric cryptococcal lymphadenitis: Report of one case

Cryptococcosis is an invasive mycotic infection caused by Cryptococcus neoformans, an encapsulated, yeast-like fungus. It is considered an opportunist infection, since it mainly affects immunocompromised subjects. However there are isolated reports of the infection in immunocompetent subjects. Cryptococcal infection of intra-abdominal organs or tissues is extremely rare. We report a 21-year-old HIV positive male that, during the treatment of a meningeal cryptococcosis, presented a clinical picture of an acute abdomen suggesting acute appendicitis. The patient was operated, finding enlarged mesenteric lymph nodes forming conglomerates and a macroscopically normal appendix. The conglomerated lymph nodes and the appendix were excised. The pathological study of the surgical piece revealed an intra abdominal cryptococcal lymphadenitis and a normal appendix.

Colecistitis aguda asociada a sepsis por Staphylococcus aureus en un recién nacido / Acute cholecystitis and Staphylococcus aureus sepsis-related in a newborn

Introducción: La colecistitis aguda es una patología muy infrecuente en el periodo neonatal. Objetivo: Presentar el caso de un recién nacido con una colecistitis aguda asociada a una sepsis por Staphylococcus aureus. Caso clínico: Recién nacido de término, de sexo femenino, de 23 días de vida, que presentó signos clínicos de septicemia, asociado a un abdomen agudo que requirió una laparotomía exploradora encontrándose una vesícula hidrópica e inflamada que requirió de una colecistectomía, la biopsia confirmó una colecistitis aguda. Conclusión: La colecistitis aguda neonatal es una patología muy infrecuente. Clínicamente se presenta como un abdomen agudo o una masa abdominal palpable. El diagnóstico se sospecha con la ecografía y se confirma por laparotomía.