Fatal meningococcal meningitis in a 2-year-old child:A case report

作     者：Aleksander Mularski Czesław Żaba 

作者机构：Department of Legal and Forensic MedicinePoznan University of Medical Sciences Institute of Forensic Research 

出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期：2019年第7卷第5期

页      面：636-641页

核心收录：

学科分类：10[医学] 

主　　题：Meningococcal infection Molecular microbiology Waterhouse-Friderichsen syndrome Neisseria meningitidis Autopsy Cerebrospinal fluid Case report 

摘      要：BACKGROUND In fatal cases of meningococcal septicemia, bacteriological diagnosis may not be straightforward due to postmortem replication and relocation of endogenic microflora. In medicolegal practice, aside from routine autopsy and histopathology, also other diagnostic methods, such as microbiological tests,immunohistochemistry and polymerase chain reaction(PCR), are used to examine body fluids and *** SUMMARY We present the case of sudden death in a 2-year-old child. The patient died approximately 30 min after hospital admission before any routine diagnostic procedures were undertaken. Presence of whole-body rash and fulminant course of the disease raised suspicion of meningococcal septicemia. An autopsy was performed seven days after death when the body showed the signs of late postmortem decomposition. No etiological factor of septicemia could be identified based on macro-and microscopic findings. However, PCR demonstrated the presence of genetic material of group W Neisseria meningitidis in patient s cerebrospinal fluid and *** Microbiological PCR should be conducted postmortem whenever a specific etiological factor could not be identified with conventional methods.