Objective: To present the first report of ruptured spleen associated with meningococcal septicaemia.
Clinical features: A 13-year-old girl presented with an acute abdomen and clinical signs of meningococcal septicaemia. Features of her illness placed her in a high mortality group.
Intervention and outcome: She required cardiovascular and respiratory support in the Intensive Care Unit. Failure to initially identify the organism led to percutaneous fine-needle aspiration of fluid in the lesser sac. A laparotomy revealed free intraperitoneal blood and a ruptured spleen. During the course of her illness she was given penicillin and methylprednisolone, and required haemodialysis. She made a complete recovery.
Conclusion: Ruptured spleen does occur with severe meningococcaemia, and may complicate management.