%0 Journal Article %1 parmentier_value_2008 %A Parmentier, Laurent %A Garzoni, Christian %A Antille, Christophe %A Kaiser, Laurent %A Ninet, Béatrice %A Borradori, Luca %D 2008 %J Archives of Dermatology %K Adolescent, Adult, Bacteremia, Bacterial Bacterial, Biopsy, Chain Chronic Diagnosis, Differential, Disease, Diseases, Humans, Infections, Male, Meningococcal Neisseria Polymerase Reaction, Skin Skin, meningitidis, {DNA,} %N 6 %P 770--773 %R 10.1001/archderm.144.6.770 %T Value of a novel Neisseria meningitidis--specific polymerase chain reaction assay in skin biopsy specimens as a diagnostic tool in chronic meningococcemia %U http://www.ncbi.nlm.nih.gov/pubmed/18559767 %V 144 %X BACKGROUND: Chronic meningococcemia (CM) is a diagnostic challenge. Skin lesions are frequent but in most cases nonspecific. Polymerase chain reaction (PCR)-based diagnosis has been validated in blood and cerebrospinal fluid for acute Neisseria meningitidis infection, in patients in whom routine microbiologic tests have failed to isolate the bacteria. In 2 patients with CM, we established the diagnosis by a newly developed PCR-based approach performed on skin biopsy specimens. OBSERVATIONS: Two patients presented with fever together with systemic and cutaneous manifestations suggestive of CM. Although findings from blood cultures remained negative, we were able to identify N meningitidis in the skin lesions by a newly developed PCR assay. In 1 patient, an N meningitidis strain of the same serogroup was also isolated from a throat swab specimen. Both patients rapidly improved after appropriate antibiotherapy. CONCLUSIONS: To our knowledge, we report the first cases of CM diagnosed by PCR testing on skin biopsy specimens. It is noteworthy that, although N meningitidis-specific PCR is highly sensitive in blood and cerebrospinal fluid in acute infections, our observations underscore the usefulness of PCR performed on skin lesions for the diagnosis of chronic N meningitidis infections. Whenever possible, this approach should be systematically employed in patients for whom N meningitidis infection cannot be confirmed by routine microbiologic investigations.

@article{parmentier_value_2008, abstract = {{BACKGROUND:} Chronic meningococcemia {(CM)} is a diagnostic challenge. Skin lesions are frequent but in most cases nonspecific. Polymerase chain reaction {(PCR)-based} diagnosis has been validated in blood and cerebrospinal fluid for acute Neisseria meningitidis infection, in patients in whom routine microbiologic tests have failed to isolate the bacteria. In 2 patients with {CM,} we established the diagnosis by a newly developed {PCR-based} approach performed on skin biopsy specimens. {OBSERVATIONS:} Two patients presented with fever together with systemic and cutaneous manifestations suggestive of {CM.} Although findings from blood cultures remained negative, we were able to identify N meningitidis in the skin lesions by a newly developed {PCR} assay. In 1 patient, an N meningitidis strain of the same serogroup was also isolated from a throat swab specimen. Both patients rapidly improved after appropriate antibiotherapy. {CONCLUSIONS:} To our knowledge, we report the first cases of {CM} diagnosed by {PCR} testing on skin biopsy specimens. It is noteworthy that, although N meningitidis-specific {PCR} is highly sensitive in blood and cerebrospinal fluid in acute infections, our observations underscore the usefulness of {PCR} performed on skin lesions for the diagnosis of chronic N meningitidis infections. Whenever possible, this approach should be systematically employed in patients for whom N meningitidis infection cannot be confirmed by routine microbiologic investigations.}, added-at = {2011-03-11T10:05:34.000+0100}, author = {Parmentier, Laurent and Garzoni, Christian and Antille, Christophe and Kaiser, Laurent and Ninet, Béatrice and Borradori, Luca}, biburl = {https://www.bibsonomy.org/bibtex/2f0521334fd56673350ad7e2e06e0f8f8/jelias}, doi = {10.1001/archderm.144.6.770}, interhash = {dcab525e01e89d4c947507319e1b1916}, intrahash = {f0521334fd56673350ad7e2e06e0f8f8}, issn = {1538-3652}, journal = {Archives of Dermatology}, keywords = {Adolescent, Adult, Bacteremia, Bacterial Bacterial, Biopsy, Chain Chronic Diagnosis, Differential, Disease, Diseases, Humans, Infections, Male, Meningococcal Neisseria Polymerase Reaction, Skin Skin, meningitidis, {DNA,}}, month = jun, note = {{PMID:} 18559767}, number = 6, pages = {770--773}, timestamp = {2011-03-11T10:06:14.000+0100}, title = {Value of a novel Neisseria meningitidis--specific polymerase chain reaction assay in skin biopsy specimens as a diagnostic tool in chronic meningococcemia}, url = {http://www.ncbi.nlm.nih.gov/pubmed/18559767}, volume = 144, year = 2008 }