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May 1991

Epidemiologic Notes and Reports: Laboratory-Acquired Meningococcemia—California and Massachusetts

Arch Dermatol. 1991;127(5):622-623. doi:10.1001/archderm.1991.01680040026002

Although Neisseria meningitidis is commonly isolated in clinical laboratories, laboratory-acquired infection is rare.1 This report describes two fatal cases of meningococcal infection in laboratory workers; both of these cases probably were laboratory acquired.

Case 1.  On March 8, 1988, a clinical laboratory bacteriologist in California became ill with influenza-like symptoms and nausea. During the next 24 hours, she developed fever, myalgias, arthralgias, diarrhea, skin lesions, and confusion. Her husband informed ambulance personnel that she had had a mishap in the laboratory approximately 1 week earlier with a type of organism that causes meningitis.When hospitalized at 10 p.m. on March 9, she was hypotensive with numerous petechial and purpuric lesions on her face, neck, trunk, and extremities; she died 6 hours later. The final autopsy diagnosis was "clinical acute intractable shock, consistent with acute meningococcemia." Blood cultures and cerebrospinal fluid studies were negative. Serum was positive by a bivalent

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