Atypical Presentation of Meningococcemia as Gastroenteritis in an Adult: A Case Report

TL;DR

A 29-year-old man presented with symptoms resembling gastroenteritis but was later diagnosed with meningococcemia, highlighting the importance of considering rare presentations of serious infections.

Contribution

This case report highlights an atypical presentation of meningococcemia in an adult with gastrointestinal symptoms rather than typical signs.

Findings

The patient presented with gastrointestinal symptoms rather than typical meningococcal disease signs like fever or rash.

Blood cultures confirmed Neisseria meningitidis serogroup W135 as the causative agent.

Prompt antibiotic treatment led to rapid clinical improvement and prevented complications.

Abstract

Meningococcal disease is a life-threatening infection that can present with diverse and sometimes atypical manifestations, making early diagnosis challenging. We report the case of a 29-year-old man who presented with acute gastrointestinal symptoms, raising suspicion for gastroenteritis. Blood cultures later identified Neisseria meningitidis serogroup W135, confirming a diagnosis of meningococcemia. Unlike the typical presentation of meningococcal disease in adults, which often features fever, hypotension, myalgias, and a characteristic petechial rash, this patient exhibited predominantly gastrointestinal manifestations without neurologic signs or rash, leading to an early diagnostic challenge. Prompt recognition and empirical antibiotic treatment resulted in rapid clinical improvement and prevention of complications. This case underscores the importance of maintaining a high index of suspicion for meningococcemia in adults presenting with sepsis, even in the absence of classic features, as early intervention remains critical to improving outcomes.

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