Fatal meningococcal septicemia without meningeal signs, contribution of the peripheral smear in diagnosis: Report of a case
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Date
2018-06
Authors
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Journal ISSN
Volume Title
Publisher
Indian Association of Pathologists and Microbiologists
Abstract
Acute meningococcemia is characterized by extensive purpurae consisting of both petechiae and ecchymoses. This condition can be rapidly fatal without treatment due to shock and severe consumptive coagulopathy. We report a case of fatal meningococcal septicemia in a military recruit who presented with fever and associated rapidly progressive purpuric rash (purpura fulminans) without any meningeal signs. Evaluation revealed evidence of disseminated intravascular coagulopathy and multiorgan failure. Diplococci were demonstrated in peripheral blood neutrophils and monocytes. On autopsy, extensive hemorrhages were found in both adrenals, lungs, liver, skin, and kidneys with secondary hemophagocytic lymphohistiocytosis in bone marrow. This report highlights useful information obtained from examination of peripheral blood smear in purpura fulminans.
Description
Keywords
Meningococcemia without meningitis, peripheral smear, postmortem, purpura fulminans
Citation
Mutreja D, Moorchung N, Manasa SJ, Varghese J. Fatal meningococcal septicemia without meningeal signs, contribution of the peripheral smear in diagnosis: Report of a case. Indian Journal of Pathology and Microbiology. 2018 Jun; 61(2): 284-286