A rare case of fulminant meningococcal sepsis with atypical manifestations: a case report

Due to its wide spectrum of clinical manifestations and severe course associated with high mortality, meningococcal infection remains a socially significant disease. Currently, an increase in cases of meningococcal infection with atypical clinical manifestations is being observed, which are characterized by higher mortality rates. This is associated both with microbiological features of the pathogen and with diagnostic and therapeutic errors in managing such patients. Early microbiological testing serves as a key diagnostic method for atypical forms of the disease. In the absence or late initiation of treatment, the generalized form of meningococcal infection almost invariably leads to death. Even with timely and adequate therapy, mortality reaches 10%–15%, and up to 20% of survivors suffer from disabling sequelae that significantly reduce quality of life. This article describes a clinical case of a generalized form of meningococcal infection in an otherwise healthy 43-year-old man. The infection was caused by a nontypeable Neisseria meningitidis, and the disease manifested as fulminant sepsis with shock, gastroenteritis, and pronounced abdominal syndrome without hemorrhagic rash or meningeal signs. Meningitis was confirmed only by histopathological examination of brain tissue. Despite intensive therapy, the infection progressed rapidly, resulting in death 18 hours after the onset of initial symptoms. This case demonstrates that the generalized form of meningococcal infection may present with sepsis and gastrointestinal symptoms in the absence of hemorrhagic rash and meningeal signs. Physicians in both outpatient and hospital settings should consider this possibility in their diagnostic evaluation.