Nav: Home

Meningococcal meningitis: Stomach pain should be seen as a warning sign

April 26, 2018

© Monet, Fotolia Patients with meningococcal infection generally develop symptoms including a high temperature, vomiting and a stiff neck... but they might also just have a bad stomach ache. This can be so severe that they are sometimes wrongly operated for appendicitis. Teams from the Institut Pasteur and the Department of Pediatrics at Bicêtre Hospital (AP-HP) decided to investigate the question. And the results speak for themselves: 10% of patients infected by the meningococcal strain that is on the rise in Europe suffer from abdominal pain. This atypical form of the disease is becoming increasingly common and needs to be brought to the attention of physicians. The findings are published in Clinical Infectious Diseases.

Within the first 24 hours of meningococcal infection - which can give rise to meningitis and septicemia as well as arthritis, peritonitis, etc. -, patients generally suffer from headaches, vomiting and a stiff neck. Over the past few years, however, abdominal pain has been observed as another early clinical sign - but physicians tend not to think of invasive meningococcal disease. "When doctors see patients suffering from stomach pain, invasive meningococcal disease doesn't immediately spring to mind. They tend to think of gastroenteritis or possibly appendicitis," explains Muhamed-Kheir Taha, lead author of the study and Head of the National Reference Center for Meningococci (CNRM) at the Institut Pasteur. "But delays in diagnosis and appropriate treatment for those affected can be deadly. Invasive meningococcal disease is fatal in virtually all cases if antibiotics are not administered rapidly." The team led by Muhamed-Kheir Taha, in collaboration with a team from the Department of Pediatrics at Bicêtre Hospital (AP-HP), decided to take a closer look at these abdominal forms to assess their frequency and raise awareness among physicians of this new face of the disease.

Since meningococcal disease is a notifiable condition, the CNRM has received all the bacterial strains responsible for meningococcal infections in France since the 1980s. So the scientists were able to analyze some 12,000 meningococcal strains kept at the CNRM between 1991 and 2016 and examine the clinical presentations of the patients infected. They isolated 105 cases associated with abdominal pain, gastroenteritis or diarrhea. "That number represents just 1% of patients, which is not very many, even if the real figure is probably higher since it is hard to know whether babies are suffering from stomach pains," says Muhamed-Kheir Taha. "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." In other words, the emergence of these new W isolates changed clinical presentations and people with meningococcal infection today are more likely to suffer from abdominal pains. So it is urgently necessary to take this symptom into consideration in medical diagnosis. Abdominal pains, together with other signs such as leg pain, headaches and poor blood supply to the nails, should raise alarm bells for meningococcal meningitis.

To investigate their findings further, the team sequenced all the genomes of the bacteria in their collection to identify what sets them apart from other strains and what might explain the resulting abdominal pains. Here again, the scientists' findings were relatively clear. The group W bacterial strain that is currently spreading across Europe and the world has around a hundred specific genes, some of which are involved in the inflammatory response. "We should remember that the bacteria infect the vessels which supply blood to the abdomen and the digestive system," emphasizes Muhamed-Kheir Taha. "If these bacteria are likely to induce a stronger inflammatory response in tissues, that could explain the abdominal pains." The scientists will continue their research by looking more closely at these genes to try to understand the mechanism of action of this strain, paving the way for more rapid diagnosis of a disease which still claims some 135,000 lives worldwide every year.
-end-


Institut Pasteur

Related Abdominal Pain Articles:

New abdominal aortic aneurysm genes identified, could help pinpoint those at risk
A study of US veterans identified 14 genes that may predict the risk of abdominal aortic aneurysm.
Advances in the detection of the postoperative progress of abdominal aortic aneurysm
A study published in Frontiers in Bioengineering and Biotechnology by a team of researchers from BCN MedTech with the VICOMTech Foundation in San Sebastian, the BioDonostia Health Research Institute and Donostia University Hospital, offers a promising methodology for post-operative CTA time-series registration and subsequent aneurysm biomechanical strain analysis, which correlates with the patient's long-term prognosis.
New opioid speeds up recovery without increasing pain sensitivity or risk of chronic pain
A new type of non-addictive opioid developed by researchers at Tulane University and the Southeast Louisiana Veterans Health Care System accelerates recovery time from pain compared to morphine without increasing pain sensitivity, according to a new study published in the Journal of Neuroinflammation.
With abdominal etching, plastic surgeons help patients get 'six-pack abs'
Even with a good diet and workout routine, some men and women have trouble getting the toned abdominal appearance they want.
App predicts risk of developing hernia following abdominal surgery
A new app can predict the likelihood that a patient will develop an incisional hernia following abdominal surgery, using big data to potentially help address a problem effects one out of every eight of these surgical patients.
Researchers uncover new cause of abdominal aortic aneurysm
Researchers have discovered that a family of lipids (fats) contribute to the development of a serious aortic disease, by driving clotting in the blood vessel wall.
Abdominal aortic calcification may signal future heart attack
Computed tomography (CT)-based measures of calcification in the abdominal aorta are strong predictors of heart attacks and other adverse cardiovascular events -- stronger even than the widely used Framingham risk score, according to a new study.
A simple measurement of abdominal obesity
In obesity research, the body mass index (BMI) has been traditionally used to determine if an individual is normal weight, underweight, overweight or obese.
Abdominal obesity linked to lower urinary tract symptoms
In a recent LUTS study, men with central (or abdominal) obesity were at increased risk of experiencing lower urinary tract symptoms, and increased waist-to-hip ratio was associated with worsened straining and weak stream.
Treating menopause symptoms reduces abdominal fat tissue
Women who undergo hormone therapy to relieve menopausal symptoms tend to have less fat tissue, particularly in the abdomen, than other menopausal women, according to a new study published in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism.
More Abdominal Pain News and Abdominal Pain Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Warped Reality
False information on the internet makes it harder and harder to know what's true, and the consequences have been devastating. This hour, TED speakers explore ideas around technology and deception. Guests include law professor Danielle Citron, journalist Andrew Marantz, and computer scientist Joy Buolamwini.
Now Playing: Science for the People

#576 Science Communication in Creative Places
When you think of science communication, you might think of TED talks or museum talks or video talks, or... people giving lectures. It's a lot of people talking. But there's more to sci comm than that. This week host Bethany Brookshire talks to three people who have looked at science communication in places you might not expect it. We'll speak with Mauna Dasari, a graduate student at Notre Dame, about making mammals into a March Madness match. We'll talk with Sarah Garner, director of the Pathologists Assistant Program at Tulane University School of Medicine, who takes pathology instruction out of...
Now Playing: Radiolab

What If?
There's plenty of speculation about what Donald Trump might do in the wake of the election. Would he dispute the results if he loses? Would he simply refuse to leave office, or even try to use the military to maintain control? Last summer, Rosa Brooks got together a team of experts and political operatives from both sides of the aisle to ask a slightly different question. Rather than arguing about whether he'd do those things, they dug into what exactly would happen if he did. Part war game part choose your own adventure, Rosa's Transition Integrity Project doesn't give us any predictions, and it isn't a referendum on Trump. Instead, it's a deeply illuminating stress test on our laws, our institutions, and on the commitment to democracy written into the constitution. This episode was reported by Bethel Habte, with help from Tracie Hunte, and produced by Bethel Habte. Jeremy Bloom provided original music. Support Radiolab by becoming a member today at Radiolab.org/donate.     You can read The Transition Integrity Project's report here.