SHM Converge Scientific Abstract ePoster Gallery-Meningococcal Bacteremia Presenting as Acute Pericarditis, a Rare Clinical Challenge

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This case report describes a 44-year-old man with diabetes, hypertension, obesity, and smoking history who presented with severe pleuritic chest pain radiating to the neck and shoulders. Because of subtle ST-segment elevation, acute coronary syndrome was initially suspected, but coronary angiography showed no significant coronary disease. Further workup revealed a subsegmental pulmonary embolism, yet the patient continued to worsen despite anticoagulation and required intra-aortic balloon pump support.<br /><br />Laboratory findings, including leukocytosis and elevated procalcitonin, suggested infection. Blood cultures identified Neisseria meningitidis bacteremia, and intravenous ceftriaxone was started. Echocardiography later demonstrated pericardial tamponade. Pericardiocentesis drained 260 mL of turbid, purulent fluid, confirming infectious pericarditis. CT angiography showed persistent pericardial inflammation and nonspecific aortic inflammation, raising concern for other inflammatory or autoimmune processes; advanced imaging helped clarify the diagnosis. Colchicine was added to treatment because of ongoing pericardial inflammation.<br /><br />The report emphasizes that meningococcal bacteremia can rarely present as acute pericarditis and can mimic more common cardiovascular emergencies such as myocardial infarction or pulmonary embolism, delaying diagnosis. The authors highlight the importance of early microbiological confirmation, multidisciplinary care, and careful use of imaging in atypical cases. While ceftriaxone was essential for treating the bacteremia, the benefit of colchicine in infectious pericarditis remains uncertain and needs further study.<br /><br />Overall, this case underscores the diagnostic and therapeutic challenges of rare meningococcal cardiac involvement, and it suggests that prompt recognition and coordinated management can lead to a favorable outcome.

Asset Subtitle

Mahra Almheiri

Meta Tag

Author List Ahmed Zyara, Mahra Almheiri, Mohamad Mooty

Category Clinical Vignettes

Concept Neisseria meningitidis

Concept Meningococcal Pericarditis

Concept Acute Pericarditis

Concept Cardiac Tamponade

Concept Echocardiography

Distinguished Non-Finalist

Presenter Organization Cleveland Clinic AbuDhabi

Presenting Author Mahra Almheiri

Track Adult

Keywords

Neisseria meningitidis

meningococcal bacteremia

infectious pericarditis

pericardial tamponade

pulmonary embolism

acute coronary syndrome

ceftriaxone

colchicine

echocardiography

pericardiocentesis

Neisseria meningitidis

Meningococcal Pericarditis

Acute Pericarditis

Cardiac Tamponade

Echocardiography