{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:51:40Z","timestamp":1791910300489,"version":"4.3.4"},"reference-count":19,"publisher":"Microbiology Society","issue":"3","license":[{"start":{"date-parts":[[2016,6,28]],"date-time":"2016-06-28T00:00:00Z","timestamp":1467072000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,6,28]]},"abstract":"<jats:sec sec-type=\"intro\">\n                  <jats:title>Introduction:<\/jats:title>\n                  <jats:p>Invasive meningococcal disease can be difficult to detect early in its course when patients may appear well and the severity of their illness is obscured by non-specific complaints.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case presentation:<\/jats:title>\n                  <jats:p>We report five cases of meningococcal sepsis in adult patients who presented to an emergency department early in the course of their disease, but whose severity of illness was not recognized.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec sec-type=\"conclusions\">\n                  <jats:title>Conclusion:<\/jats:title>\n                  <jats:p>Suspicion of meningococcal sepsis should be heightened in the setting of hypotension, tachycardia, elevated shock index, leukopaenia with left shift, thrombocytopaenia and hypokalaemia, prompting early sepsis care.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1099\/jmmcr.0.005027","type":"journal-article","created":{"date-parts":[[2016,6,23]],"date-time":"2016-06-23T09:13:21Z","timestamp":1466673201000},"source":"Crossref","is-referenced-by-count":5,"title":["Delayed recognition of fatal invasive meningococcal disease in adults"],"prefix":"10.1099","volume":"3","author":[{"given":"Frederick W.","family":"Nagel","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, North Central Bronx Hospital, Albert Einstein College of Medicine, Bronx, NY, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ifeoma","family":"Ezeoke","sequence":"additional","affiliation":[{"name":"New York City Department of Health and Mental Hygiene, New York, NY, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mike","family":"Antwi","sequence":"additional","affiliation":[{"name":"New York City Department of Health and Mental Hygiene, New York, NY, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula E.","family":"Del Rosso","sequence":"additional","affiliation":[{"name":"New York City Department of Health and Mental Hygiene, New York, NY, United 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