[Two case reports of meningococcemia. Review of the literature on chronic meningococcemia].

INTRODUCTION: Neisseria meningitidis is a Gram-negative bacteria that can be highly pathogenic in humans and responsible for life-threatening and acute diseases. In a few cases, it can lead to an atypical form of sepsis-acute, subacute, or chronic-which, even if progression is slower, may carry the same risks for patients as conventional acute forms.

CASES: Case 1 presented with recurrent fever, polyarthralgia, and generalized macular rash. Case 2 had fever for the previous 10days with neck pain and macular rash. Blood cultures were positive for group B meningococcus in both cases. Polymerase chain reaction (PCR) analysis for the same pathogen was also positive in the cerebrospinal fluid (CSF) of Case 2. Following intravenous antibiotic treatment, the progression was favorable in both cases.

DISCUSSION: Chronic meningococcemia is characterized by a triad of clinical features, including a fever lasting for at least 1week, arthralgia, and a cutaneous rash. This condition evolves positively without any sequelae if treated properly. PCR and blood culture are two complimentary tools that support the diagnosis.

CONCLUSION: Meningococcal infection can manifest in a variety of ways. Chronic meningococcemia diagnosis should be considered in a triad of prolonged fever, rash, and arthralgia. Better access to state-of-the-art techniques such as PCR is recommended in the future so as to provide optimal care of patients suffering from this condition.