Korean J Pediatr Infect Dis.  2004 May;11(1):126-130. 10.14776/kjpid.2004.11.1.126.

A Case of Combined Acute Poststreptococcal Glomerulonephritis and Acute Invasive Meningococcal Disease

• Jeon H
• Hahn W
• Park D
• Cha S

• KMID: 2440078
• DOI: http://doi.org/10.14776/kjpid.2004.11.1.126

Abstract

Neisseria meningitidis is a leading cause of meningitis and septicemia in children and young adults. Meningococcemia, the most severe form of infection, represents a part of the various spectrum of the illness, and its clinical manifestations varied from mild fever and occult bacteriemia to fulminant catastrophic events(e.g., sepsis, shock, and death) within a few hours after onset of symptoms. Complement deficiencies, either congenital or acqired, increase the risk for invasive meningococcal disease. Since C3 plays a critical role in the complement cascade, congenital C3 deficiency or conditions that decrease C3(e.g., systemic lupus erythematosus, cirrhosis, nephritis, C3 nephritic factor) increase the risk for invasive disease due to pyogenic bacteria including N. meningitidis. We had experienced a case of meningococcemia and meningococcal meningitis presenting with mild fever, petechiae, and purpura. The patient was a 7-year old male. He had mild fever, vomiting, headache, nuchal rigidity, petechiae and purpura on both lower extremities, which spreaded to the whole body. His blood culture grew Neisseria meningitidis. The diagnosis of meningococcal meningitis was confirmed by examination of cerebrospinal fluid. The clinical symptoms of the illness were improved after treatment of antibiotics(cefotaxime) for 12 days. However the patient had developed generalized edema, microscopic hematuria & proteinuria on the third day after admission. High ASO titer and low serum C3 level were also noted. The microscopic hematuria returned to normal about 2 months after discharge. The C3 level returned to normal range about 3~4 months after discharge. we report a case of combined acute poststreptococcal glomerulonephritis and acute invasive meningococcal disease with reference review.

Keyword

Meningococcal disease; Group A streptococci; Glomerulonephritis; Complement C3

MeSH Terms

Bacteria
Cerebrospinal Fluid
Child
Complement C3
Complement System Proteins
Diagnosis
Edema
Fever
Fibrosis
Glomerulonephritis*
Headache
Hematuria
Humans
Lower Extremity
Lupus Erythematosus, Systemic
Male
Meningitis
Meningitis, Meningococcal
Muscle Rigidity
Neisseria meningitidis
Nephritis
Proteinuria
Purpura
Reference Values
Sepsis
Shock
Vomiting
Young Adult
Complement C3
Complement System Proteins