Abstract
Two co-primary cases of schoolchildren with acute meningococcal disease due to infection withNeisseria meningitidis serogroup B are described. The first patient presented with septic shock and purpura fulminans, bacteremia greater than 105 organisms/ml blood, low C3 and factor B levels and an elevated level of C3d. The second patient had meningitis, negative blood cultures, normal levels of serum complement components but more than 104 organisms/ml in CSF. A comparison of the quantitative bacteriology data and complement profiles for these patients suggests that the degree of activation of complement during meningococcemia is directly related to the number of organisms in the blood. This association may determine the different clinical syndromes.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Petersen, B. H., Lee, T. J., Snydermann, R., Brooks, G. F.:Neisseria meningitidis andNeisseria gonorrhea bacteremia associated with C6, C7, or C8 deficiency. Annals of Internal Medicine 1979, 90: 917–920.
Holmes, F. F., Weyandt, T., Glazier, J., Cuppage, F. E., Moral, L. A., Lindsey, N. J.: Fulminant meningococcemia after splenectomy. Journal of American Medical Association 1981, 246: 1119–1120.
Davis, C. E., Arnold K.: Role of meningococcal endotoxin in meningococcal purpura. Journal of Experimental Medicine 1974, 140: 159–171.
Fearon, D. T., Ruddy, S., Schur, P. H., McCabe, W. R.: Activation of the properdine pathway of complement in patients with gram-negative bacteremia. New England Journal of Medicine 1975, 292: 937–940.
Frank, M. M., May, J. E., Kane, M. A.: Contributions of the classical and alternate pathways to the biological effects of endotoxin. Journal of Infectious Diseases 1973, 129 (Supplement): 176–181.
Jacob, J. S., Craddock, P. R., Hammerschmidt, D. E., Moldow, C. F.: Complement-induced granulocyte aggregation. An unsuspected mechanism of disease. New England Journal of Medicine 1980, 302: 789–794.
Greenwood, B. W., Onyewotu, I. I., Whittle, H. C.: Complement and meningococcal infection. British Medical Journal 1976, 1: 797–799.
Zwahlen, A., Nydegger, U. E., Vaudaux, P., Lambert, P. H., Waldvogel, F. A.: Complement-mediated opsonic activity in normal and infected human cerebrospinal fluid: early response during bacterial meningitis. Journal of Infectious Diseases 1982, 145: 635–646.
Perrin, L. H., Lambert, P. H., Miescher, P. A.: Complement breakdown products in plasma from patients with systemic lupus erythematosus and patients with membranoproliferative or other glomerulonephritis. Journal of Clinical Investigation 1975, 56: 165–176.
Santosham, M., Moxon, E. R.: Detection and quantitation of bacteremia in childhood. Journal of Pediatrics 1977, 91: 719–721.
Feldman, W. E.: Relation of concentrations of bacteria and bacterial antigen in cerebrospinal fluid to prognosis in patients with bacterial meningitis. New England Journal of Medicine 1977, 296: 433–435.
Simberkoff, M. S., Moldover, N. H., Rahal, J. J. Jr: Absence of detectable bactericidal and opsonic activities in normal and infected human cerebrospinal fluids: a regional host defense deficiency. Journal of Laboratory and Clinical Medicine 1980, 95: 362–372.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Zwahlen, A., Waldvogel, F.A. Magnitude of bacteremia and complement activation duringNeisseria meningitidis infection: Study of two co-primary cases with different clinical presentations. Eur. J. Clin. Microbiol. 3, 439–441 (1984). https://doi.org/10.1007/BF02017367
Issue Date:
DOI: https://doi.org/10.1007/BF02017367