SHM Converge Scientific Abstract ePoster Gallery-Primary Meningococcal Pericarditis in a Human Immunodeficiency Virus Positive Patient

Pdf Summary

This case describes a 31-year-old HIV-positive man who presented with chest pain, shortness of breath, and vomiting. He was initially discharged from the emergency room after a negative cardiac evaluation, but returned two days later with worsening symptoms. Testing showed a moderate pericardial effusion and mildly reduced left ventricular ejection fraction (45%) on transthoracic echocardiogram, but no tamponade or hemodynamic compromise.<br /><br />Blood cultures grew Neisseria meningitidis, and pericardiocentesis removed 335 mL of purulent fluid that also cultured positive for N. meningitidis. A lumbar puncture did not suggest meningitis, and cerebrospinal fluid cultures were negative. The findings supported a diagnosis of primary meningococcal pericarditis (PMP), a rare and difficult-to-recognize form of pericardial infection.<br /><br />The report emphasizes that meningococcal pericarditis can be classified as disseminated disease with pericarditis, reactive pericarditis, or primary pericarditis. PMP is especially dangerous because it is often missed early and can be associated with high mortality. Although it commonly presents with tamponade or cardiovascular collapse, this patient did not, showing that PMP can occur without classic severe hemodynamic findings.<br /><br />The authors note that PMP in an HIV-positive patient has not been previously reported, and they suggest that impaired immune response may have contributed to the presentation. The case highlights the importance of obtaining blood cultures in patients with unexplained pericardial effusion and shows that pericardiocentesis can serve both diagnostic and therapeutic purposes in invasive pyogenic infections.<br /><br />Overall, the report advises clinicians to consider meningococcal pericarditis in at-risk groups, including students, military personnel, unvaccinated individuals, and immunocompromised patients.

Asset Subtitle

Alynna Knaub

Meta Tag

Author List Alexandra Mari, Alynna Knaub, Deepak Talreja, Kaivalya Dandamudi

Category Clinical Vignettes

Concept Meningococcal Pericarditis

Concept Pericardial Effusion

Concept Pericardiocentesis

Concept Mortality

Concept Blood Culture

Distinguished Non-Finalist

Presenter Organization Eastern Virginia Medical School

Presenting Author Alynna Knaub

Track Adult

Keywords

Neisseria meningitidis

primary meningococcal pericarditis

HIV-positive

pericardial effusion

pericardiocentesis

blood cultures

purulent pericarditis

echocardiogram

immunocompromised

meningococcal infection

Meningococcal Pericarditis

Pericardial Effusion

Pericardiocentesis

Mortality

Blood Culture