Abstract
Meningococcal disease is an infection caused by Neisseria meningitidis. The disease can have catastrophic consequences in individuals and can become epidemic in developed and developing countries (Buysse et al., 2008). In Brazil, neisserial infection is endemic and presents a cyclic pattern, the majority of cases occurring during the winter. At the Emílio Ribas Institute of Infectology, located in the city of São Paulo, the incidence of meningococcal disease is approximately 100 cases per year (de Souza et al., 2007a). We have observed a broad range of clinical presentations of N. meningitidis infection, including atypical complications and dramatic manifestations such as purpura fulminans (de Souza et al., 2006a, 2007b; Marotto et al., 1997). In fact, this malady has been linked to a constellation of pathophysiological phenomena: euthyroid sick syndrome (Joosten et al., 2000), acute renal failure (Marotto et al., 1997), acute respiratory distress syndrome (Eisenhut et al., 2006), cerebrovascular disease (de Souza et al., 2008a, b), brain abscess (Rothbaum et al., 2006), atrioventricular-node inflammation (Robboy, 1972), primary meningococcal conjunctivitis (Barquet et al., 1990), intrauterine meningococcal infection (Bhutta et al., 1991), electrolyte and acid-base disturbances (Holland et al., 2002; Kornelisse et al., 1997), peritonitis (de Souza et al., 2006b), pericarditis (de Souza et al., 2006c), cellulites (Kennedy et al., 2006), myocardial dysfunction (Pathan et al., 2004), endocarditis (Arias et al., 2007), urethritis (Urra et al., 2005) and rhabdomyolysis (van Deuren et al., 1998).