Primary meningococcal pericarditis (PMP) is a rare form of acute purulent pericarditis that often evolves into cardiac tamponade and usually requires pericardial drainage. PMP is a rare, difficult to diagnose, rapidly progressive form of meningococcal infections. PMP is typically caused by Neisseria meningitidis of serotype C, or, less commonly, B or W135. We report the second case of PMP caused by Neisseria meningitidis of serotype Y. Our patient was not critically ill at presentation, and her presentation could have been consistent with viral uncomplicated pericarditis with the exception of the mild leukocytosis with a left shift in the differential. Clinicians should be aware that early in the course of PMP, the illness may not be severe. Mild leukocytosis with a left shift or bandemia in the setting of what otherwise seems to be a case of uncomplicated viral pericarditis should prompt suspicion for PMP and further evaluation and/or monitoring.
This is a preview of subscription content, log in to check access.
There authors have not received any funding for the work presented in this manuscript. The authors report no relevant conflicts of interest or financial interests related to this manuscript, including employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
Finkelstein Y, Adler Y, Nussinovitch M, et al. A new classification for pericarditis associated with meningococcal infection. Eur J Pediatr. 1997;156:585–8.PubMedCrossRefGoogle Scholar
Blaser MJ, Reingold AL, Alsever RN, et al. Primary meningococcal pericarditis: A disease of adults associated with serogroup C neisseria meningitidis. Rev Infect Dis. 1984;6:625–32.PubMedGoogle Scholar
Simon HB, Tarr PI, Hutter AM, et al. Primary meningococcal pericarditis. diagnosis by counter-current immunoelectrophoresis. JAMA. 1976;235:278–80.PubMedCrossRefGoogle Scholar
Hardy DJ, Bartholomew WR, Amsterdam D. Pathophysiology of primary meningococcal pericarditis associated with neisseria meningitidis group C. A case report and review of the literature. Diagn Microbiol Infect Dis. 1986;4:259–65.PubMedCrossRefGoogle Scholar
Falcao SN, Tsutsui JM, Ramires FJ, et al. The role of echocardiography in diagnosis and management of isolated meningococcal pericarditis. Echocardiography. 2007;24:263–6.PubMedCrossRefGoogle Scholar
Kwa R, Kumar R, Varriale P. Primary meningococcal pericarditis with tamponade. N Y State J Med. 1981;81:79–81.PubMedGoogle Scholar
de Souza AL, Marques Salgado M, Romano CC, et al. Cytokine activation in purulent pericarditis caused by neisseria meningitidis serogroup C. Int J Cardiol. 2006;113:419–21.PubMedCrossRefGoogle Scholar
Leite de Souza A, Salgado MM, Alkmin MD, et al. Purulent pericarditis caused by neisseria meningitidis serogroup C and confirmed through polymerase chain reaction. Scand J Infect Dis. 2006;38:143–5.CrossRefGoogle Scholar
Vienne P, Ducos-Galand M, Guiyoule A, et al.. The role of particular strains of Neisseria meningitidis in meningococcal arthritis, pericarditis, and pneumonia. Clin Infect Dis. 2003;37:1639–42.PubMedCrossRefGoogle Scholar