8. What is the significance of arthritis after meningococcal meningitis? A significant number of patients with meningococcal disease develop inflammatory polyarthritis about a week after the onset of infection. In most cases, this is a sterile, immune complex phenomenon that responds to anti-inflammatory therapy. If joint effusions are present, they should be aspirated to exclude septic arthritis and crystalline arthritis. TH
Dr. Ross is a hospitalist at Brigham and Women’s Hospital (Boston) and a fellow of the Infectious Diseases Society of America.
References
- Hasbun R, Abrahams J, Jekel J, et al. Computed tomography of the head before lumbar puncture in adults with suspected meningitis. N Engl J Med. 2001 Dec 13;345(24):1727-1733.
- de Gans J, van de Beek D. Dexamethasone in adults with bacterial meningitis. European dexamethasone in adulthood bacterial meningitis. N Engl J Med. 2002;347(20):1549-156.
- Tunkel AR, Hartman BJ, Kaplan SL, et al. Practice guidelines for the management of bacterial meningitis. Clin Infect Dis. 2004 Nov 1;39(9):1267-1284.
- van de Beek D, de Gans J, Tunkel AR, et al. Community-acquired bacterial meningitis in adults. N Engl J Med. 2006 Jan 5;354(1):44-53.