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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="research-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Epidemiology and Infectious Diseases</journal-id><journal-title-group><journal-title xml:lang="en">Epidemiology and Infectious Diseases</journal-title><trans-title-group xml:lang="ru"><trans-title>Эпидемиология и инфекционные болезни</trans-title></trans-title-group></journal-title-group><issn publication-format="print">3034-2007</issn><issn publication-format="electronic">3034-2015</issn><publisher><publisher-name xml:lang="en">Eco-Vector</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">677096</article-id><article-id pub-id-type="doi">10.17816/EID677096</article-id><article-id pub-id-type="edn">AQSYJZ</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Case reports</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>Клинические случаи</subject></subj-group><subj-group subj-group-type="article-type"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">A rare case of fulminant meningococcal sepsis with atypical manifestations: a case report</article-title><trans-title-group xml:lang="ru"><trans-title>Редкий случай фульминантного менингококкового сепсиса с атипичными проявлениями: клинический случай</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5080-6529</contrib-id><contrib-id contrib-id-type="spin">8921-4689</contrib-id><name-alternatives><name xml:lang="en"><surname>Galeeva</surname><given-names>Nelli V.</given-names></name><name xml:lang="ru"><surname>Галеева</surname><given-names>Нелли Васильевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Cand. Sci. (Medicine), Assistant Professor</p></bio><bio xml:lang="ru"><p>канд. мед. наук, доцент</p></bio><email>nelli_04@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0104-5895</contrib-id><contrib-id contrib-id-type="spin">4103-5663</contrib-id><name-alternatives><name xml:lang="en"><surname>Nikolaeva</surname><given-names>Irina V.</given-names></name><name xml:lang="ru"><surname>Николаева</surname><given-names>Ирина Венидиктовна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Dr. Sci. (Medicine), Professor</p></bio><bio xml:lang="ru"><p>д-р мед. наук, профессор</p></bio><email>irinanicolaeva@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0004-3505-2166</contrib-id><contrib-id contrib-id-type="spin">8772-3423</contrib-id><name-alternatives><name xml:lang="en"><surname>Fatkullin</surname><given-names>Bulat Sh.</given-names></name><name xml:lang="ru"><surname>Фаткуллин</surname><given-names>Булат Шамилиевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Cand. Sci. (Medicine)</p></bio><bio xml:lang="ru"><p>канд. мед. наук</p></bio><email>bulat.fatkullin.68@bk.ru</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0000-3524-9250</contrib-id><contrib-id contrib-id-type="spin">6757-9412</contrib-id><name-alternatives><name xml:lang="en"><surname>Gimadieva</surname><given-names>Ilyuza R.</given-names></name><name xml:lang="ru"><surname>Гимадиева</surname><given-names>Илюза Радиковна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>ilyuza_gimadiyeva@mail.ru</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8124-5880</contrib-id><contrib-id contrib-id-type="spin">7307-6339</contrib-id><name-alternatives><name xml:lang="en"><surname>Gaynatullina</surname><given-names>Liliya R.</given-names></name><name xml:lang="ru"><surname>Гайнатуллина</surname><given-names>Лилия Рифкатовна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>g-lilya@mail.ru</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2637-9982</contrib-id><contrib-id contrib-id-type="spin">5067-7210</contrib-id><name-alternatives><name xml:lang="en"><surname>Sharafutdinova</surname><given-names>Adelya R.</given-names></name><name xml:lang="ru"><surname>Шарафутдинова</surname><given-names>Аделия Радиковна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>Adeliasudmed@mail.ru</email><xref ref-type="aff" rid="aff3"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Kazan State Medical University</institution></aff><aff><institution xml:lang="ru">Казанский государственный медицинский университет</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">Professor A.F. Agafonov Republican Clinical Infectious Diseases Hospital</institution></aff><aff><institution xml:lang="ru">Республиканская клиническая инфекционная больница им. проф. А.Ф. Агафонова</institution></aff></aff-alternatives><aff-alternatives id="aff3"><aff><institution xml:lang="en">Republican Bureau of Forensic Medical Examination, Kazan</institution></aff><aff><institution xml:lang="ru">Республиканское бюро судебно-медицинской экспертизы, Казань</institution></aff></aff-alternatives><pub-date date-type="preprint" iso-8601-date="2025-09-05" publication-format="electronic"><day>05</day><month>09</month><year>2025</year></pub-date><pub-date date-type="pub" iso-8601-date="2025-10-09" publication-format="electronic"><day>09</day><month>10</month><year>2025</year></pub-date><volume>30</volume><issue>2</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>129</fpage><lpage>136</lpage><history><date date-type="received" iso-8601-date="2025-03-12"><day>12</day><month>03</month><year>2025</year></date><date date-type="accepted" iso-8601-date="2025-06-11"><day>11</day><month>06</month><year>2025</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2025, Eco-vector</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2025, Эко-вектор</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="en">Eco-vector</copyright-holder><copyright-holder xml:lang="ru">Эко-вектор</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/" start_date="2028-10-09"/><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by-nc-nd/4.0/</ali:license_ref></license></permissions><self-uri xlink:href="https://rjeid.com/1560-9529/article/view/677096">https://rjeid.com/1560-9529/article/view/677096</self-uri><abstract xml:lang="en"><p>Due to its wide spectrum of clinical manifestations and severe course associated with high mortality, meningococcal infection remains a socially significant disease.</p> <p>Currently, an increase in cases of meningococcal infection with atypical clinical manifestations is being observed, which are characterized by higher mortality rates. This is associated both with microbiological features of the pathogen and with diagnostic and therapeutic errors in managing such patients. Early microbiological testing serves as a key diagnostic method for atypical forms of the disease. In the absence or late initiation of treatment, the generalized form of meningococcal infection almost invariably leads to death. Even with timely and adequate therapy, mortality reaches 10%–15%, and up to 20% of survivors suffer from disabling sequelae that significantly reduce quality of life.</p> <p>This article describes a clinical case of a generalized form of meningococcal infection in an otherwise healthy 43-year-old man. The infection was caused by a nontypeable <italic>Neisseria meningitidis</italic>, and the disease manifested as fulminant sepsis with shock, gastroenteritis, and pronounced abdominal syndrome without hemorrhagic rash or meningeal signs. Meningitis was confirmed only by histopathological examination of brain tissue. Despite intensive therapy, the infection progressed rapidly, resulting in death 18 hours after the onset of initial symptoms.</p> <p>This case demonstrates that the generalized form of meningococcal infection may present with sepsis and gastrointestinal symptoms in the absence of hemorrhagic rash and meningeal signs. Physicians in both outpatient and hospital settings should consider this possibility in their diagnostic evaluation.</p></abstract><trans-abstract xml:lang="ru"><p>Менингококковая инфекция остаётся социально значимым заболеванием из-за широкого спектра клинических проявлений и тяжёлого течения с высокой летальностью.</p> <p>В настоящее время отмечают рост числа случаев менингококковой инфекции с атипичными клиническими проявлениями, для которых характерны более высокие показатели летальности. Это связано как с микробиологическими особенностями возбудителя, так и с ошибками в диагностике и лечении таких пациентов. Раннее микробиологическое исследование служит ключевым методом диагностики атипичных форм заболевания. При отсутствии или позднем начале лечения генерализованная форма менингококковой инфекции почти всегда приводит к летальному исходу. Даже при своевременной и адекватной терапии уровень смертности достигает 10–15%, а до 20% выживших пациентов страдают от инвалидизирующих последствий, значительно ухудшающих качество жизни.</p> <p>В статье описан клинический случай генерализованной формы менингококковой инфекции у практически здорового мужчины 43 лет. Инфекцию вызвала нетипируемая <italic>Neisseria meningitidis</italic>, и заболевание протекало в форме фульминантного сепсиса с шоком, гастроэнтеритом и выраженным абдоминальным синдромом без геморрагической сыпи и менингеальных знаков. Менингит подтвердили только при патоморфологическом исследовании ткани головного мозга. Несмотря на интенсивную терапию, инфекция протекала молниеносно, летальный исход наступил через 18 ч после проявления первых симптомов.</p> <p>Представленный случай демонстрирует, что генерализованная форма менингококковой инфекции может проявляться симптомами сепсиса с гастроинтестинальным синдромом без геморрагической сыпи и менингеальных знаков. Врачи как амбулаторного, так и госпитального звена должны учитывать эту возможность при диагностике.</p></trans-abstract><kwd-group xml:lang="en"><kwd>meningococcal infections</kwd><kwd>sepsis</kwd><kwd>Neisseria meningitidis</kwd><kwd>case report</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>менингококковая инфекция</kwd><kwd>сепсис</kwd><kwd>Neisseria meningitidis</kwd><kwd>клинический случай</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>State report «On the state of sanitary and epidemiological welfare of the population in the Russian Federation in 2021. Moscow; 2022. (In Russ.) Available from: https://rospotrebnadzor.ru/documents/details.php?ELEMENT_ID=21796</mixed-citation></ref><ref id="B2"><label>2.</label><mixed-citation>Kutishcheva IA, Martynova GP. Meningococcal infection in the Krasnoyarsk territory. 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