Heart damage during meningococcal infection

Background. Meningococcal infection (MI) remains relevant in the modern world. In the Russian Federation, there is currently an increase in cases of meningococcal infection in the adult population. While the generalized form of meningococcal infection presents a recognizable clinical picture with the development of hemorrhagic rash and meningitis, localized and rare forms of this infection are diagnosed extremely rarely. The true proportion of rare forms in the structure of meningococcal infection remains unknown. Cardiac involvement is the most commonly registered rare form of meningococcal infection after pneumonia; it can manifest as endocarditis, myocarditis, and pericarditis. The present paper provides a literature review of available data on the forms, pathogenesis, clinical picture, diagnosis, and approaches to the treatment of meningococcal pericarditis, myocarditis, and endocarditis. The nonspecificity of clinical symptoms and laboratory tests makes it difficult to suspect meningococcal infection in patients with cardiac infections. The lack of availability in real clinical practice of diagnostic methods such as MRI, endomyocardial biopsy, and pericardiocentesis leads to low detection of these forms, especially in patients with isolated cardiac involvement of meningococcal etiology. The need for selective nutrient media to detect the pathogen also contributes to the lack of identification of the etiological factor. Conclusion. A significant problem is the absence of clinical recommendations and treatment protocols for meningococcal cardiac involvement in patients without signs of the generalized form of MI. The complexity of diagnosing and treating meningococcal pericarditis is illustrated in the present paper by a clinical example.