PRIMARY MENINGOCOCCAL ARTHRITIS

Since the first description of epidemic spinal meningitis in 1805, infection with Neisseria meningitidis continues to be a cause of worldwide epidemic disease. The clinical spectrum of meningococcal infection ranges from asymptomatic carriage to fulminant sepsis, with meningitis and septicemia as well-recognized clinical presentations. However, the ability of the organism to cause focal disease is often overlooked. The three cases presented here highlight the importance of recognizing the wider spectrum of disease caused by the organism. Meningococcal infection must be considered in the diagnosis of any child who presents with arthritis with or without rash, even if afebrile on presentation.