A complicated simple fall – an atypical case of serogroup Y meningococcal pneumonia with secondary septicaemia and literature review

An elderly lady was admitted for pain management and rehabilitation following a fall. During her stay she developed a new heart murmur and sepsis. Subacute bacterial endocarditits was excluded, empirical ciprofloxacin was initiated and later converted to aztreonam with gentamicin for clinical deteri...

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Bibliographic Details
Published in:BMJ Case Reports 2012, Vol.2012
Main Authors: Chan, BKY, Kudsk-Iversen, S, Balaguruswamy, S, Purewal, TS
Format: Report
Language:English
Online Access:Get full text
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Summary:An elderly lady was admitted for pain management and rehabilitation following a fall. During her stay she developed a new heart murmur and sepsis. Subacute bacterial endocarditits was excluded, empirical ciprofloxacin was initiated and later converted to aztreonam with gentamicin for clinical deterioration. Subsequent investigations revealed meningococcal Y septicaemia secondary to pneumonia, with a possible oropharynx focus. Upon discharge she had returned to baseline state. The case reflects an unusual and increasing cause of pneumonia. A steady increase of infective serogroup Y isolates over the past 12-years in England, with tendency towards elderly makes it a significant differential among the general medical population. This trend corresponds with the US, but is yet unknown whether to be a periodic cycle or true change in dominance and, or, virulence among serogroups. If the latter were true, it would support the inclusion of serogroups beyond menigitides C in the vaccination program.
ISSN:1757-790X
DOI:10.1136/bcr.11.2011.5095