Academic journal article Iranian Journal of Public Health

An Adolescent Boy Presenting with Complicated Meningococcal Meningitis Serogroup A: What Is the State of Community Awareness for This Serious Disease?

Academic journal article Iranian Journal of Public Health

An Adolescent Boy Presenting with Complicated Meningococcal Meningitis Serogroup A: What Is the State of Community Awareness for This Serious Disease?

Article excerpt

Dear Editor-in-Chief

Invasive meningococcal disease (IMD), which may be highly variable spectrum of clinical mani- festations, is important for acute and chronic complications in the age groups of children and adolescents (1,2). There is limited information re- garding community and awareness of IMD, espe- cially in the adolescents as a target group (3,4). The assessment of community knowledge and awareness of IMD have to be known to under- stand the general public's view of the disease in order to help developing community educational programs targeted to specific age groups. Other- wise, an unconscious community against this seri- ous disease that can be fatal may be led to irre- versible and life-threat complications in surviving patients.

To support this opinion, we report a 17-year-old boy, who is a member of a family of low socioec- onomic level and working as a construction work- er, diagnosed as meningococcal meningitis with- out any history of meningococcal vaccine. He had a delayed admission to hospital about 3 days due to lack of awareness that the cause of his symp- toms may be meningitis. The patient was admitted with fever, headache, nausea lasting for three days and bilateral hearing impairment appearing on the last day. In physical examination, he had neck stiffness together with positive Kernig and Bru- dzinski signs, bilateral intermittent horizontal nys- tagmus. A lumbar puncture was performed with a preliminary diagnosis of meningitis to the patient who had leukocytosis (18300/μL [N: 3,5- 10,5X103/μL]), elevated C reactive protein (21 mg/dL [N: 0-0,5] ) and elevated erythrocyte sedi- mentation rate (N: 120 mm/hr [0-20]) in blood studies. In the examination of cerebrospinal fluid (CSF), amorphous polymorphonuclear leucocytes in Giemsa stain and Gram negative diplococci in Gram stain were present along with high protein level (169 mg/dL [N: 15-45]) and low glucose lev- el (35 mg/dL [N: 40-70]) with accompanying 138 mg/dL blood glucose. The CSF culture of the pa- tient yielded Neisseria meningitidis without concomi- tant blood culture positivity, and serogroup typing investigation resulted as serogroup A. The patient was treated with ceftriaxone for 10 days. The signs of meningitis and nystagmus healed after antibi- otic-therapy, but bilateral hearing loss continued as a sequela of the disease. The patient was con- sulted to the otorhinolaryngology department be- cause of hearing loss after cranial and temporal computed tomography imaging revealed normal results. …

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