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[Primary meningococcal B osteomyelitis and arthritis with multifocal pyomyositis in a child: a case report].
[pyomyositis]
Neisseria
meningitidis
is
associated
with
severe
invasive
infections
such
as
meningitis
and
fulminant
septicemia
.
Septic
arthritis
due
to
N
.
meningitidis
is
rare
and
bone
infections
have
been
reported
exceptionally
.
We
report
the
case
of
a
7
-
year
-old
boy
who
presented
with
septic
arthritis
of
the
right
hip
associated
with
a
septic
location
on
the
pelvis
and
pyomyositis
of
the
adjacent
muscle
.
Culture
of
the
joint
fluid
was
sterile
but
universal
16
S
polymerase
chain
reaction
(
PCR
)
of
this
fluid
revealed
group
B
N
.
meningitidis
.
Our
patient
had
never
presented
any
symptoms
of
meningitis
or
septicemia
and
blood
cultures
were
all
sterile
.
Despite
appropriate
antibiotic
treatment
,
the
course
of
the
disease
was
unusually
long
and
his
status
did
not
improve
until
surgical
lavage
of
the
hip
was
performed
.
Moreover
,
MRI
imaging
showed
bilateral
hypersignals
of
the
adjacent
muscles
and
revealed
an
abscess
formation
in
the
left
gluteus
maximus
muscle
.
Presumptive
diagnosis
bacterial
myositis
was
confirmed
by
an
elevation
of
creatine
phosphokinase
in
the
sera
up
to
21
-
fold
the
normal
value
but
the
culture
of
the
abscess
,
performed
10
days
after
initiation
of
antibiotics
,
was
sterile
.
Despite
an
initially
unfavorable
course
,
this
patient
's
status
improved
after
surgical
drainage
and
he
fully
recovered
1
month
later
.
This
observation
illustrates
an
unusual
presentation
of
invasive
meningococcal
infection
.
The
respective
roles
of
infection
and
an
inflammatory
phenomenon
during
the
course
of
the
disease
are
discussed
.
Moreover
,
this
case
emphasizes
the
value
of
PCR
for
bacteriological
diagnosis
of
bone
and
joint
infections
.
