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  • Fulminant invasive meningococcal disease due to serogroup Y infection: a highly unusual case reflecting worrying increases in carriage and incidence

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Reminder of important clinical lesson
CASE REPORT
Fulminant invasive meningococcal disease due to serogroup Y infection: a highly unusual case reflecting worrying increases in carriage and incidence
  1. Akash Maniam1⇑,
  2. Sriram Ravichandran2
  1. 1 ITU and Anaesthetics, Barnet Hospital, London, UK
  2. 2 Haematology, Barnet Hospital, London, UK
  1. Correspondence to Dr Akash Maniam, ITU and Anaesthetics, Barnet Hospital, London EN5 3DJ, UK; akash.maniam{at}nhs.net

Summary

A young man presented to accident and emergency with a short history of diarrhoea and vomiting, with no medical history. He deteriorated rapidly during triage and never regained consciousness. He was pronounced dead after hours of attempted resuscitation. He was found to have organisms suggestive of diplococci on his blood film and subsequently had MenY found via PCR testing. This case illustrates a highly unusual presentation of invasive meningococcal disease caused by MenY which is quietly and dangerously increasing in incidence in the UK, particularly in young healthy patients. All clinicians are reminded to be vigilant in order to diagnose and treat this often fatal disease as well as to promote uptake of the quadrivalent MenACWY vaccine.

  • Global Health
  • Healthcare improvement and patient safety
  • Infectious diseases
  • Meningitis
  • Travel medicine

https://doi.org/10.1136/bcr-2017-219510

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    Footnotes

    • Contributors I hereby certify that SR and I, AM, collaborated together during our time at Barnet Hospital to produce this manuscript. SR presented me with this case, which I wrote in its entirety, while researching the literature used in this case. SR supervised me during this process and reviewed my draft and edited it to our mutually agreed final version. For this paper, it has been agreed that I shall be the first author and he shall be the second author.

    • Competing interests None declared.

    • Patient consent Patient is deceased. After exhaustive attempts, we were unable to contact his next of kin for this. We have anonymised the information contained in this case as much as possible and have ensured that this will not cause harm to the patient's family, to the best of our ability. We take full responsibility for this manuscript and the attempts to contact the deceased patient's family. We strongly believe that it is in the best interests of society to have the awareness from this case, which did not require any sensitive or identifying patient information.

    • Provenance and peer review Not commissioned; externally peer reviewed.