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February 1975

Acute Meningococcal Pericarditis Without Meningitis

Author Affiliations

From the Division of Infectious Diseases, Department of Medicine, Michael Reese Hospital and Medical Center, and the Department of Medicine, University of Chicago, Pritzker School of Medicine, Chicago.

Arch Intern Med. 1975;135(2):314-316. doi:10.1001/archinte.1975.00330020118016

Infection with Neisseria meningitidis accounts for 4% of cases of purulent pericarditis.1 Meningococcal pericarditis usually is a complication of the acute or convalescent phase of meningococcal meningitis. It occurred in 4.3% of meningitis patients in the preantibiotic era2 and 5.1% or less in the antibiotic era.3,4 Four cases of meningococcal pericarditis without meningitis have been reported.5-8 We report a fifth case that is the first to lack major pericardial effusion. In consequence, the clinical syndrome resembled acute benign pericarditis.

Patient Summary  An 18-year-old man was well until Oct 5, 1972, when he developed cough and sore throat that subsided spontaneously in a few days. Sharp, substernal chest pain started a week later, four hours prior to admission to the emergency room at Michael Reese Hospital and Medical Center. The pain was severe and constant, radiating to his neck and both shoulders. It was aggravated by respiration