Meningococcal Pericarditis

Abstract

A diagnosis of pericarditis was made in five patients with acute meningococcal infections, including three from a recent series of 97 cases. Evidence for pericarditis was present in four of the five patients upon admission to the hospital, and all demonstrated the typical features of pericardial involvement, including electrocardiographic abnormalities, cardiac silhouette enlargement on x-ray film, and pericardial friction rubs. The course was uncomplicated in three patients, while two developed cardiac tamponade, necessitating pericardiocentesis. Reaccumulation of fluid was felt to be prevented by the administration of corticosteroids. A review of the past and present cases suggests that the pericarditis occurring early in the course of meningococcal disease is due to invasion of the pericardium by the organism, while its appearance later in the illness is a hypersensitivity reaction, initiated by the earlier bacterial invasion.