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January 19, 1976

Primary Meningococcal Pericarditis: Diagnosis by Counter-Current Immunoelectrophoresis

Author Affiliations

From the departments of medicine (Drs Simon and Hutter) and surgery (Dr Erdmann), Massachusetts General Hospital, the Department of Medicine, Children's Hospital Medical Center (Mr Tarr), and the Harvard Medical School, Boston.

JAMA. 1976;235(3):278-280. doi:10.1001/jama.1976.03260290036024

PURULENT pericarditis is an uncommon disorder that often escapes clinical detection despite its lifethreatening nature.1 Appropriate management requires vigorous antimicrobial therapy and, in most cases, surgical drainage. Identification of the responsible pathogen is of paramount importance. We report a patient with pericardial tamponade who was found to have primary meningococcal pericarditis. The diagnosis was suggested by the Gram stain of the pericardial fluid, but, because the patient had recently been given antibiotics, cultures were negative. A new technique, counter-current immunoelectrophoresis (CIE), was used to confirm the etiologic diagnosis. This is, to our knowledge, the first time CIE has been used successfully in the diagnosis of purulent pericarditis.

Report of a Case  A 49-year-old mother of four was in excellent health until 10:45 AM on Aug 1, 1974, when she experienced an abrupt rigor followed promptly by fever and diffuse myalgia. She remained bedridden for 48 hours, with fever, sweats,