Benign Meningococcemia in Childhood: A Report of Five Cases with Clinical and Diagnostic Remarks

Abstract

Five children aged 1/2-10 yr with benign meningococcemia are reported. The clinical picture was quite uniform: good general condition, spikes of fever, skin eruptions as maculopapules, sometimes hemorrhagic, appearing in association with febrile periods, and arthralgia (big joints). The diagnosis involves isolation of meningococci (MC) from blood, demonstration of MC with immunofluorescence in skin eruptions, or a significant elevation of MC antibody titer in connection with typical clinical signs and symptoms. Important differential diagnoses are Henoch-Schoenlein syndrome, disseminated gonococcal infection, septicemia of other origins, subacute bacterial endocarditis, viral infections, hypersensitivity reactions and subsepsis allergica. By co-agglutination technique, the causative agent of meningococcemia in 4 of the 5 children was shown to be MC group B. These have some features in common with gonococci, whereby an incorrect diagnosis might be suggested as demonstrated in one of the patients. The question is raised whether MC group B is the main causative agent in benign meningococcemia.