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April 2, 1982

Neisseria meningitidis Serogroup W-135 Disease in Adults

JAMA. 1982;247(13):1810. doi:10.1001/jama.1982.03320380016013

To the Editor.—  The article by Brandstetter et al (1981;246:2060) has prompted us to report another case of Neisseria meningitidis serogroup W-135 infection in an adult. Our patient had primary pericarditis with cardiac tamponade. An earlier case of tamponade due to this organism was reported by Kwa et al.1

Report of a Case.—  A 45-year-old, previously healthy man had symptoms suggestive of pericarditis. There was no fever or pericardial rub. The chest x-ray film was normal. The ECG suggested pericarditis with ST-segment elevation. A diagnosis of idiopathic pericarditis was made and the patient was treated with corticosteroids. His condition improved transiently; however, on the fourth hospital day atrial fibrillation, hypotension, and dyspnea developed. An echocardiogram was technically difficult, and no pericardial fluid was demonstrated. Because of the neck vein distention and clinical course, a tamponade was suspected, and pericardiocentesis was done, yielding 200 mL of purulent fluid and relief