Meningococcaemia with arthritis

ABSTRACT

A patient is described with acute meningococcaemia and arthritis, but without meningitis. Although he had a positive blood culture, repeated synovial fluid cultures were sterile. Over the course of his illness and as his septicemia recovered with antibiotic treatment, the pattern of his arthritis changed from that of a polyarthritis to oligoarthritis and then a monoarthritis of the left knee. The knee deteriorated in fact while all the other features showed complete recovery. Repeated aspirations of the knee involved did not help. However, a local injection of a depot preparation of methylprednisolone into the involved knee led to a quick and complete recovery. This paper reviews different patterns of arthritis due to meningococcal infection and discusses its management