Meningococcal meningitis complicated by septic shock, myocarditis and purpura fulminans

Meningococcal disease is a rapidly progressive, life-threatening infection caused by Neisseria meningitidis. Typical presentations include meningitis, septicaemia, or a combination of the two. Rarely, it can be complicated by purpura fulminans and myocarditis, contributing to increased morbidity and mortality. We report a case of a previously healthy 16-year-old boy presenting with a 3-day history of fever, headache and altered consciousness. He was hypotensive, febrile and tachycardic on admission, with a purpuric skin rash suggestive of purpura fulminans and neck stiffness. Investigations revealed leukocytosis, thrombocytopenia, elevated inflammatory markers, and cerebrospinal fluid analysis consistent with bacterial meningitis. PCR confirmed Neisseria meningitidis. Elevated troponin I and echocardiography indicated myocarditis. He was treated in the ICU with fluids, inotropes and intravenous ceftriaxone. The patient made a full recovery, with normalisation of cardiac function and inflammatory markers. This case underscores the severe and aggressive nature of meningococcal disease, emphasising the importance of early recognition and timely multidisciplinary intervention in preventing poor outcomes in healthy individuals.