Clinical case of co-infection: COVID19 and invasive meningococcal infection

In light of the current pandemic, doctors need to raise the suspicion of concurrent SARS-CoV-2 infection with Neisseria meningitides infection. In this article we reported a case of invasive meningococcal infection in an adolescent with COVID-19. Severity of the disease depended on septic shock due to invasive meningococcal infection associated with sepsis and meningitis. The differential diagnosis with a multisystem inflammatory syndrome was tricky considering the fever, shock, meningeal symptoms, elevated levels of C-reactive protein and D-dimer, patient age, and a positive test for SARS-CoV-2. The disease outcome was good. Given the risk of invasive forms of meningococcal infection, the possible synergy of SARS-CoV-2 and Neisseria meningitidis, the complexity of differential diagnosis in patients in critical condition, immunization against meningococcal infection should be carried out according to epidemic indications, despite the COVID-19 pandemic.Copyright © 2022 Sorbtsionnye i Khromatograficheskie Protsessy. All rights reserved.

Clinical and laboratory characteristic of patients with COVID-19 and meningococcal co-infection.

Objective. To analyze clinical and laboratory characteristics of patients with COVID-19 and meningococcal co-infection. Patients and methods. We analyzed cases of mixed infection caused by SARS-CoV-2 and meningococci in 8 patients treated in Moscow Multidisciplinary Clinical Center 'Kommunarka.' We used mass spectrometry for microbiological examination followed by culturing in accordance with the results of examination. All patients were tested positive for COVID-19 by PCR and meningococcal infection by bacteriological method. Results. Patients were admitted to hospital on average 5.88 +/- 4.2 days after COVID-19 onset. Two patients had moderate disease, whereas 6 patients had severe disease and were admitted to the intensive care unit. Study participants presented with different forms of meningococcal infection, including nasopharyngitis (n = 1), meningitis (n = 1), pneumonia (n = 2), menin-gococcemia (n = 3), and mixed form meningitis and meningococcemia (n = 1). Fatal outcome was observed in 37.5% of cases. Conclusion. The problem of meningococcal infection remains highly relevant during the COVID-19 pandemic. So-infection is characterized by an increase in the proportion of rare forms (pneumonia), which requires special attention of clinicians. The implementation of mass spectrometry will allow early detection of meningococcal infection in patients with rare forms and timely initiation of adequate and optimal therapy. Copyright © 2022.

Clinical and laboratory characteristic of patients with COVID-19 and meningococcal co-infection

Objective. To analyze clinical and laboratory characteristics of patients with COVID-19 and meningococcal co-infection. Patients and methods. We analyzed cases of mixed infection caused by SARS-CoV-2 and meningococci in 8 patients treated in Moscow Multidisciplinary Clinical Center 'Kommunarka.' We used mass spectrometry for microbiological examination followed by culturing in accordance with the results of examination. All patients were tested positive for COVID-19 by PCR and meningococcal infection by bacteriological method. Results. Patients were admitted to hospital on average 5.88 +/- 4.2 days after COVID-19 onset. Two patients had moderate disease, whereas 6 patients had severe disease and were admitted to the intensive care unit. Study participants presented with different forms of meningococcal infection, including nasopharyngitis (n = 1), meningitis (n = 1), pneumonia (n = 2), menin-gococcemia (n = 3), and mixed form meningitis and meningococcemia (n = 1). Fatal outcome was observed in 37.5% of cases. Conclusion. The problem of meningococcal infection remains highly relevant during the COVID-19 pandemic. So-infection is characterized by an increase in the proportion of rare forms (pneumonia), which requires special attention of clinicians. The implementation of mass spectrometry will allow early detection of meningococcal infection in patients with rare forms and timely initiation of adequate and optimal therapy. Copyright © 2022.

Clinical case of co-infection: COVID19 and invasive meningococcal infection

In light of the current pandemic, doctors need to raise the suspicion of concurrent SARS-CoV-2 infection with Neisseria meningitides infection. In this article we reported a case of invasive meningococcal infection in an adolescent with COVID-19. Severity of the disease depended on septic shock due to invasive meningococcal infection associated with sepsis and meningitis. The differential diagnosis with a multisystem inflammatory syndrome was tricky considering the fever, shock, meningeal symptoms, elevated levels of C-reactive protein and D-dimer, patient age, and a positive test for SARS-CoV-2. The disease outcome was good. Given the risk of invasive forms of meningococcal infection, the possible synergy of SARS-CoV-2 and Neisseria meningitidis, the complexity of differential diagnosis in patients in critical condition, immunization against meningococcal infection should be carried out according to epidemic indications, despite the COVID-19 pandemic. © 2022 Sorbtsionnye i Khromatograficheskie Protsessy. All rights reserved.

Clinical Outcome and Underlying Genetic Cause of Functional Terminal Complement Pathway Deficiencies in a Multicenter UK Cohort.

BACKGROUND: Terminal complement pathway deficiencies often present with severe and recurrent infections. There is a lack of good-quality data on these rare conditions. This study investigated the clinical outcome and genetic variation in a large UK multi-center cohort with primary and secondary terminal complement deficiencies. METHODS: Clinicians from seven UK centers provided anonymised demographic, clinical, and laboratory data on patients with terminal complement deficiencies, which were collated and analysed. RESULTS: Forty patients, median age 19 (range 3-62) years, were identified with terminal complement deficiencies. Ten (62%) of 16 patients with low serum C5 concentrations had underlying pathogenic CFH or CFI gene variants. Two-thirds were from consanguineous Asian families, and 80% had an affected family member. The median age of the first infection was 9 years. Forty-three percent suffered meningococcal serotype B and 43% serotype Y infections. Nine (22%) were treated in intensive care for meningococcal septicaemia. Two patients had died, one from intercurrent COVID-19. Twenty-one (52%) were asymptomatic and diagnosed based on family history. All but one patient had received booster meningococcal vaccines and 70% were taking prophylactic antibiotics. DISCUSSION: The genetic etiology and clinical course of patients with primary and secondary terminal complement deficiency are variable. Patients with low antigenic C5 concentrations require genetic testing, as the low level may reflect consumption secondary to regulatory defects in the pathway. Screening of siblings is important. Only half of the patients develop septicaemia, but all should have a clear management plan.