Chronic meningococcemia in childhood: case report and review of the literature.

Chronic meningococcemia is a rare form of meningococcal infection. Most reported cases occur in adults. Only about 10% of reported patients are under 18 years of age. We herein report chronic meningococcemia in a 17-month-old immunocompetent child and review the literature. Our patient had a 4-month history of several episodes of intermittent fever accompanied by widespread erythematous and purpuric, crusted papules and pustules with necrotic centers. Blood cultures were positive for group C Neisseria meningitidis. Histopathology of a skin biopsy specimen revealed leukocytoclastic vasculitis. Because the disease is uncommon and can be confused with other conditions including other infectious processes, vasculitis, and collagen vascular diseases, it is important to have a high degree of suspicion for chronic meningococcemia. This will help avoid a delayed diagnosis and/or inappropriate treatment. The positive blood culture remains the diagnostic sine qua non. Treatment with ceftriaxone was rapidly successful in our patient.