SHM Converge Scientific Abstract ePoster Gallery-Neisseria Meningitidis Bacteremia Presenting as Septic Arthritis in a Type Ii Diabetic Experiencing Homelessness

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This case report describes a 52-year-old woman with type 2 diabetes, hypertension, and osteoarthritis who presented with acute right knee pain, swelling, fever, malaise, and chills. Examination showed an erythematous, swollen, tender knee with limited range of motion and inability to bear weight. Laboratory tests revealed leukocytosis, neutrophilia, and elevated CRP. Synovial fluid was purulent with a very high white blood cell count and 98% neutrophils; Gram stain showed Gram-negative diplococci. Blood cultures identified serogroup B <em>Neisseria meningitidis</em>.

The patient was evaluated for common risk factors for invasive meningococcal disease, including complement deficiency, HIV, and asplenia. Complement studies were normal, HIV testing was negative, and she had no history of splenectomy. Her main identified risk factors were type 2 diabetes and communal living/homelessness. Knee X-ray showed an effusion. Orthopedic surgery performed irrigation and debridement, and she was treated with ceftriaxone 2 g IV daily for 4 weeks.

At 6-week follow-up, she had full joint mobility without residual pain or inflammation. The report emphasizes that <em>N. meningitidis</em> is an uncommon but important cause of acute monoarthritis and should be considered even when classic signs of meningococcemia, such as rash or hemodynamic instability, are absent. The knee is the joint most commonly affected. Early joint aspiration, culture, empiric antibiotics, and surgical management were essential to prevent long-term joint damage. The case also highlights the importance of screening for risk factors and notifying public health authorities, since meningococcal disease is reportable.

Asset Subtitle

Anukriti Singh

Meta Tag

Author List Anukriti Singh, John M. Cunningham

Category Clinical Vignettes

Concept Neisseria meningitidis

Concept Septic Arthritis

Concept Monoarticular Arthritis

Concept Synovial Fluid Analysis

Concept Blood Culture Testing

Distinguished Non-Finalist

Presenter Organization University of Texas Health Science Center at San Antonio Joe R. And Teresa Lozano Long School of Medicine

Presenting Author Anukriti Singh

Track Adult

Keywords

Neisseria meningitidis

septic arthritis

monoarthritis

type 2 diabetes

right knee

Gram-negative diplococci

ceftriaxone

joint aspiration

irrigation and debridement

meningococcal disease

Neisseria meningitidis

Septic Arthritis

Monoarticular Arthritis

Synovial Fluid Analysis

Blood Culture Testing