Primary meningococcal arthritis in a COVID-19 18-year-old man: a case report and review of the literature

BMC Infect Dis. 2021 May 29;21(1):499. doi: 10.1186/s12879-021-06211-7.

Abstract

Background: SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection is associated with various complications. PMA (primary meningococcal arthritis) is a rare meningococcus-associated disease causing arthritis of the knee usually, without any signs of invasive meningococcal disease. No case of PMA in a COVID-19 (coronavirus disease, 2019) patient has yet been described. PMA mainly strikes young adults. PMA is not associated with any immunocompromising condition. It has a better outcome than usual septic arthritis CASE PRESENTATION: Herein, we report an 18-year-old man diagnosed with COVID-19, later admitted with persistent fever, right knee arthralgia and maculopapular rash. Due to family history, psoriasis and Henoch-Schönlein purpura were hypothesized and ruled out. Finally, synovial fluid culture confirmed Neisseria meningitidis serogroup B arthritis without any other symptoms of invasive meningococcal disease. Healing was achieved quickly with surgery and antibiotics. We concluded in a PMA.

Conclusion: We describe here the first primary meningococcal arthritis in a COVID-19 patient and we hope to shine a light on this rare but serious complication.

Keywords: Arthritis; COVID-19; Neisseria meningitidis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adolescent
  • Anti-Bacterial Agents
  • Arthritis, Infectious / diagnosis*
  • Arthritis, Infectious / microbiology
  • COVID-19 / complications*
  • Exanthema / microbiology
  • Humans
  • Knee Joint / microbiology
  • Male
  • Meningococcal Infections / diagnosis*
  • Neisseria meningitidis, Serogroup B / isolation & purification
  • Synovial Fluid / microbiology

Substances

  • Anti-Bacterial Agents