{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T06:36:58Z","timestamp":1789799818251,"version":"4.0.1"},"reference-count":33,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,5,12]]},"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:p>A man in his 80s presented to the hospital with a 36-hour history of fever, myalgia, bilateral shoulder and right knee pain. Joint fluid aspirates from his shoulders and right knee isolated Gram-negative diplococci. After failing to grow on standard and selective media, <jats:italic>Neisseria meningitidis<\/jats:italic> was identified by 16s PCR and subsequently typed as serogroup C. He had no clinical features of meningitis or meningococcaemia. Blood cultures were negative and an EDTA blood sample was negative for meningococcal ctrA gene. Urine PCR was negative for <jats:italic>Neisseria gonorrhoeae<\/jats:italic>. He was treated successfully with two arthroscopic joint washouts of his right knee, aspirates of both shoulders, 40 days of intravenous ceftriaxone and intensive physiotherapy as both an inpatient and outpatient. In the literature, we have not found any previously documented cases of serogroup C meningococcus causing polyarticular primary septic arthritis in this age group or guidance on duration of antibiotic treatment. Literature on the impact of rehabilitation to baseline function was also found to be lacking. Although rare, primary meningococcal arthritis (PMA) should be considered as a differential diagnosis in cases of acute polyarticular septic arthritis. Polyarticular PMA in older adults may require prolonged rehabilitation before one might expect to return to premorbid function.<\/jats:p>","DOI":"10.1136\/bcr-2019-233378","type":"journal-article","created":{"date-parts":[[2020,6,12]],"date-time":"2020-06-12T05:57:05Z","timestamp":1591941425000},"page":"e233378","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["<i>Neisseria meningitidis<\/i> serogroup C causing primary polyarthritis in an octogenarian"],"prefix":"10.1136","volume":"13","author":[{"given":"Thomas William","family":"Noteman","sequence":"first","affiliation":[{"name":"Trauma & Orthopaedics, NHS Forth Valley, Larbert, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taegyeong Tina","family":"Ha","sequence":"additional","affiliation":[{"name":"Trauma & Orthopaedics, NHS Forth Valley, Larbert, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elan Micha","family":"Tsarfati","sequence":"additional","affiliation":[{"name":"Microbiology, NHS Forth Valley, Larbert, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,6,11]]},"reference":[{"key":"2025082711320956000_13.6.e233378.1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-6-64"},{"key":"2025082711320956000_13.6.e233378.2","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-012-1610-1"},{"key":"2025082711320956000_13.6.e233378.3","doi-asserted-by":"publisher","DOI":"10.1097\/MAJ.0b013e318142bb0d"},{"key":"2025082711320956000_13.6.e233378.4","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268800066449"},{"key":"2025082711320956000_13.6.e233378.5","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1128\/jcm.32.2.323-330.1994","article-title":"Asymptomatic carriage of Neisseria meningitidis in a randomly sampled population","volume":"32","author":"Caugant","year":"1994","journal-title":"J Clin Microbiol"},{"key":"2025082711320956000_13.6.e233378.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)00279-7"},{"key":"2025082711320956000_13.6.e233378.7","doi-asserted-by":"publisher","DOI":"10.1086\/428590"},{"key":"2025082711320956000_13.6.e233378.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2016.03.006"},{"key":"2025082711320956000_13.6.e233378.9","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61016-2"},{"key":"2025082711320956000_13.6.e233378.10","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1007\/s40121-016-0107-0","article-title":"Meningococcal vaccinations","volume":"5","author":"Crum-Cianflone","year":"2016","journal-title":"Infect Dis Ther"},{"key":"2025082711320956000_13.6.e233378.11","doi-asserted-by":"publisher","DOI":"10.1086\/379719"},{"key":"2025082711320956000_13.6.e233378.12","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1097\/00005792-199309000-00002","article-title":"Polyarticular septic arthritis","volume":"72","author":"Dubost","year":"1993","journal-title":"Medicine"},{"key":"2025082711320956000_13.6.e233378.13","doi-asserted-by":"publisher","DOI":"10.1097\/00006454-199703000-00018"},{"key":"2025082711320956000_13.6.e233378.14","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0212922","article-title":"Culture and real-time polymerase chain reaction sensitivity in the diagnosis of invasive meningococcal disease: does culture miss less severe cases?","volume":"14","author":"Guiducci","year":"2019","journal-title":"PLoS One"},{"key":"2025082711320956000_13.6.e233378.15","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1053\/j.jfas.2013.12.019","article-title":"Primary meningococcal septic arthritis of the ankle joint: a case report","volume":"53","author":"Gee","year":"2014","journal-title":"J Foot Ankle Surg"},{"key":"2025082711320956000_13.6.e233378.16","doi-asserted-by":"publisher","DOI":"10.1258\/jrsm.96.5.237"},{"key":"2025082711320956000_13.6.e233378.17","doi-asserted-by":"publisher","DOI":"10.1016\/S0163-4453(98)80182-5"},{"key":"2025082711320956000_13.6.e233378.18","article-title":"Group C Neisseria meningitidis as a cause of septic arthritis in a native shoulder joint: a case report","volume":"2011","author":"Garner","year":"2011","journal-title":"Case Rep Orthop"},{"key":"2025082711320956000_13.6.e233378.19","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1007\/s00113-014-2716-y","article-title":"[Primary meningococcal infection of the knee. 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