Atypical Meningococcemia: Diagnostic Lessons From a Fatal Case
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by Alun Evans
January 12, 2026
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3 min
7 Key Takeaways
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1
Invasive meningococcal disease can present without classic symptoms.
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2
Case involved a woman with chronic liver disease and gastrointestinal signs.
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3
Initial diagnosis did not consider meningococcal disease due to absence of rash.
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4
Key symptoms included severe shock and lactic acidosis.
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5
Risk factor awareness is crucial for diagnosing atypical presentations.
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6
Rapid empirical treatment with ceftriaxone is essential.
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7
Report cases early for public health management.
A recent case study highlights the atypical presentation of invasive meningococcal disease in a middle-aged woman with chronic liver disease, who displayed gastrointestinal symptoms instead of the traditional rash. Following international travel to Brazil, she presented with fever, abdominal pain, and rapidly progressed to septic shock and coagulopathy. The absence of classic signs complicates early diagnosis, underscoring the need for awareness among infectious disease physicians to include meningococcal disease in differential diagnoses, particularly in patients with risk factors like liver dysfunction.
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