Simply looking out for the classic warning signs of a meningococcal infection may cause some cases to go unnoticed - at first. A new study from the Institut Pasteur shows that abdominal pain should be considered an important symptom that occurs as a result of meningococcal infection.
Meningococcal disease is defined by the Centers for Disease Control and Prevention (CDC) as any illness caused by the bacteria Neisseria meningitidis. Infections from this pathogen spread through respiratory and throat secretions and can affect the brain and spinal cord (meningitis) and the bloodstream (bacteremia, septicemia).
Vaccines are the best way to prevent meningococcal infections. They can also be treated with antibiotics, administered as soon as possible for the best results. The classic symptoms of a meningococcal infection include fever, headache, vomiting, and stiff neck, which occur within 24 hours of infection with the bacteria. Now, severe stomach pain is becoming more common. Often this pain is so intense that it is misdiagnosed as appendicitis.
"When doctors see patients suffering from stomach pain, invasive meningococcal disease doesn't immediately spring to mind,” explained lead author Muhamed-Kheir Taha. “They tend to think of gastroenteritis or possibly appendicitis.”
But now, nearly ten percent of patients infected by a particular meningococcal strain becoming more common in Europe suffer from stomach pain.
“Delays in diagnosis and appropriate treatment for those affected can be deadly,” Taha said. “Invasive meningococcal disease is fatal in virtually all cases if antibiotics are not administered rapidly."
The new study analyzed nearly 12,000 meningococcal strains and the “clinical presentations” of the patients infected with them. Researchers saw 105 cases of abdominal pain, gastroenteritis, or diarrhea - about one percent of patients between 1991 and 2016.
"But if we focus on the past two or three years and the group W bacterial strain, which arrived in Europe in 2013-2014 and has grown rapidly ever since, the figure rises to 10% of cases,” Teha explained.
The study results show that stomach pain, along with other potential warning signs that might become increasingly common (leg pain, headaches, poor blood supply to the nails), should be considered along with the classic signs for meningococcal infection for doctors making diagnoses. In the meantime, researchers will continue investigating the relationship between stomach pain and meningococcal infection.
"We should remember that the bacteria infect the vessels which supply blood to the abdomen and the digestive system," Taha concluded. "If these bacteria are likely to induce a stronger inflammatory response in tissues, that could explain the abdominal pains."
The present study was published in the journal Clinical Infectious Diseases.