Scientific article

Value of a novel Neisseria meningitidis--specific polymerase chain reaction assay in skin biopsy specimens as a diagnostic tool in chronic meningococcemia

Published inArchives of dermatology, vol. 144, no. 6, p. 770-773
Publication date2008

BACKGROUND: Chronic meningococcemia (CM) is a diagnostic challenge. Skin lesions are frequent but in most cases nonspecific. Polymerase chain reaction (PCR)-based diagnosis has been validated in blood and cerebrospinal fluid for acute Neisseria meningitidis infection, in patients in whom routine microbiologic tests have failed to isolate the bacteria. In 2 patients with CM, we established the diagnosis by a newly developed PCR-based approach performed on skin biopsy specimens. OBSERVATIONS: Two patients presented with fever together with systemic and cutaneous manifestations suggestive of CM. Although findings from blood cultures remained negative, we were able to identify N meningitidis in the skin lesions by a newly developed PCR assay. In 1 patient, an N meningitidis strain of the same serogroup was also isolated from a throat swab specimen. Both patients rapidly improved after appropriate antibiotherapy. CONCLUSIONS: To our knowledge, we report the first cases of CM diagnosed by PCR testing on skin biopsy specimens. It is noteworthy that, although N meningitidis-specific PCR is highly sensitive in blood and cerebrospinal fluid in acute infections, our observations underscore the usefulness of PCR performed on skin lesions for the diagnosis of chronic N meningitidis infections. Whenever possible, this approach should be systematically employed in patients for whom N meningitidis infection cannot be confirmed by routine microbiologic investigations.

  • Adolescent
  • Adult
  • Bacteremia/diagnosis/etiology
  • Biopsy
  • Chronic Disease
  • DNA, Bacterial/analysis
  • Diagnosis, Differential
  • Humans
  • Male
  • Meningococcal Infections/diagnosis/microbiology
  • Neisseria meningitidis/genetics/isolation & purification
  • Polymerase Chain Reaction/methods
  • Skin/microbiology/pathology
  • Skin Diseases, Bacterial/complications/diagnosis/microbiology
NoteErratum in: Arch Dermatol. 2008 Sep;144(9):1182.
Citation (ISO format)
PARMENTIER, Laurent et al. Value of a novel Neisseria meningitidis--specific polymerase chain reaction assay in skin biopsy specimens as a diagnostic tool in chronic meningococcemia. In: Archives of dermatology, 2008, vol. 144, n° 6, p. 770–773. doi: 10.1001/archderm.144.6.770
Main files (1)
Article (Accepted version)
Secondary files (1)
ISSN of the journal0003-987X

Technical informations

Creation08/13/2009 3:04:00 PM
First validation08/13/2009 3:04:00 PM
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