An apparently healthy 18-year-old boy developed chronic bacteremia with Neisseria meningitidis, group C, without marked debility. Clinical manifestations included fever, skin rash, arthralgia, and headache. Serial immunoglobulin assays revealed the presence of a mild IgM deficiency and the absence of an IgG elevation in response to the infection. Titers of antimeningococcal antibodies to group C and group A meningococci, as determined by indirect immunofluorescence, revealed a disproportionately low IgM antibody response. The occurrence of this relatively rare form of meningococcal disease may be related to a mild immunological deficiency which is not detectable by routine laboratory tests and which is otherwise unassociated with an obvious susceptibility to infection.
Fass RJ, Saslaw S. Chronic Meningococcemia: Possible Pathogenic Role of IgM Deficiency. Arch Intern Med. 1972;130(6):943–946. doi:10.1001/archinte.1972.03650060129024
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