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Neisseria meningitidis Isolated in Vitreous Humor in a 5-Month-Old Infant Death From Meningococcal Sepsis

Garland, Jack, BMed*; Philcox, Winston, BHSc; Kesha, Kilak, MD; Playle, Veronica, MBChB§; Perera, Shanika, MBChB, MPH, FAFPHM; O'Regan, Toni, MBChB; Stables, Simon, MNZM, MBChB, DAvMed, AsFACAsM, FNZSP, FRCPA; Tse, Rexson, BSc, MBBS, FRCPA

The American Journal of Forensic Medicine and Pathology: June 2019 - Volume 40 - Issue 2 - p 175–177
doi: 10.1097/PAF.0000000000000448
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Diagnosing sepsis at postmortem is challenging. With respect to meningococcal sepsis, the postmortem microbiological identification of Neisseria meningitidis is nearly always due to true infection, including in cases of decomposition. Previous case series and case reports were able to isolate N. meningitidis in vitreous humor in adult deaths from meningococcal sepsis when blood and/or cerebrospinal fluid was unavailable. It was suggested that vitreous humor polymerase chain reaction (PCR) may be useful in the diagnosis of meningococcal sepsis. We describe a fatal case of meningococcal sepsis in a 5-month-old infant where N. meningitidis was detected in vitreous humor, cerebrospinal fluid, and blood through PCR. The presented case report gives further evidence in the potential use of vitreous PCR analysis in suspected meningococcal sepsis, particularly in the pediatric population.

From the *Hornsby Ku-Ring-Gai Hospital, Hornsby, New South Wales, Australia;

Faculty of Medical and Health Sciences, University of Auckland;

Departments of Forensic Pathology and

§Microbiology, LabPLUS, Auckland City Hospital; and

Auckland Regional Public Health Service, Auckland; and

Department of Forensic Pathology, MedLab Central, Palmerston North Hospital, Palmerston North, New Zealand.

Manuscript received September 4, 2018; accepted October 3, 2018.

The authors report no conflict of interest.

Reprints: Jack Garland, BMed, Resident Support Unit, Hornsby Ku-ring-gai Hospital, Hornsby 2077, Australia. E-mail: Jack.Garland@health.nsw.gov.au; j_k_garland@yahoo.com.au.

© 2019 by Lippincott Williams & Wilkins.