A case report on meningococcal septicaemia in Kalabazaar, Thimphu, November 2016

Tsheten ., Sonam Wangchuk, Mimi Lhamu Mynak, Tenzin Lhaden


We report here a case study of meningococcal septicaemia caused by Neisseria meningitidis in Kalabazaar, Thimphu on November 2016. The one-year old patient had no history of contact with any infected individuals in the past two weeks before his onset, neither did he travel anywhere besides his one-storey traditional residence. The patient was hospitalized and given antibiotic treatment of ceftriaxone at an early course of the disease. The patient did not develop any complications during the time of hospitalization and had recovered well. Close contacts with the case were identified and given post-exposure prophylaxis with 500 mg ciprofloxacin. No new cases were encountered during the course of contact tracing. 


Meningococcal septicaemia, Close contacts, Active surveillance, Bhutan

Full Text:



Tirani M, Meregaglia M, Melegaro A. Health and economic outcomes of introducing the new MenB vaccine (Bexsero) into the Italian routine infant immunisation programme. PloS one. 2015;10(4):0123383.

Sadarangani M, Scheifele DW, Halperin SA, Vaudry W, Le Saux N, Tsang R, et al. Outcomes of invasive meningococcal disease in adults and children in Canada between 2002 and 2011: a prospective cohort study. IDSA. 2015;60(8):27-35.

Skoczynska A, Kadlubowski M, Knap J, Szulc M, Janusz-Jurczyk M, Hryniewicz W. Invasive meningococcal disease associated with a very high case fatality rate in the North-West of Poland. FEMS Immunol Med Microbiol. 2006;46(2):230-5.

Azzari C, Canessa C, Lippi F, Moriondo M, Indolfi G, Nieddu F, et al. Distribution of invasive meningococcal B disease in Italian pediatric population: implications for vaccination timing. Vaccine. 2014;32(10):1187-91.

Ministry of Health (Bhutan). Annual health bulletin. 2016.

Clinical and laboratory standards institute. Performance standards for antimicrobial suceptibility testing. 26 edition. Wayne, PA: 2016.

Gomi H, Unuma N, Nakao K, Morisawa Y. Meningococcal meningitis with meningococcemia: a rare sporadic case in an elderly patient with no history of contact with infected individuals. Jpn J Infect Dis. 2015;68(1):67-9.

World Health Organization. Meningococcal meningitis. Available at:

centre/factsheets/fs141/en/. Accessed on 10 November 2016.

Park K. Park's textbook of preventive and social medicine. 21 edition. Jabalpur: M/s Banarsidas Bhanot; 2011.

Maat M, Buysse CM, Emonts M, Spanjaard L, Joosten KF, de Groot R, et al. Improved survival of children with sepsis and purpura: effects of age, gender, and era. Critical care. 2007;11(5):112.

Kiray Bas E, Bulbul A, Comert S, Uslu S, Arslan S, Nuhoglu A. Neonatal infection with Neisseria meningitidis: analysis of a 97-year period plus case study. JCM. 2014;52(9):3478-82.

Mairey E, Genovesio A, Donnadieu E, Bernard C, Jaubert F, Pinard E, et al. Cerebral microcirculation shear stress levels determine Neisseria meningitidis attachment sites along the blood-brain barrier. JEM. 2006;203(8):1939-50.