Fulminant serogroup B meningococcemia in an adolescent vaccinated against serogroups A and C: highlighting the serogroup B vaccination gap in China-a case report and literature review.
4 affiliations
- 1Department of Pediatrics, Huidong County People's Hospital, Huizhou, Guangdong, China.
- 2Pediatric Intensive Care Unit, Huizhou Central People's Hospital, Huizhou, Guangdong, China.
- 3Department of Laboratory Medicine, Huidong County People's Hospital, Huizhou, Guangdong, China.
- 4Department of Gastroenterology, Henan Children's Hospital Zhengzhou Children's Hospital, Henan, China.
Abstract
Background
Invasive meningococcal disease (IMD) remains an acute clinical challenge associated with high mortality and permanent disability. Although routine immunization has successfully suppressed historical lineages, an expanding epidemiological shift toward serogroup B in specific regions has exposed a population vulnerability, given that protein-based serogroup B vaccines are excluded from China's National Immunization Program (NIP, historically referred to as EPI). We present a case that characterizes the clinical trajectory of this vaccination mismatch.Case presentation
We report a case of a 12-year-old boy from Guangdong Province, China, who had previously received vaccination against Neisseria meningitidis serogroups A and C. He presented with fever and a rapidly progressive purpuric rash. Within hours, his condition deteriorated to septic shock, disseminated intravascular coagulation (DIC), and multiple organ dysfunction syndrome (MODS), consistent with purpura fulminans. Blood cultures confirmed N. meningitidis serogroup B. Following aggressive intensive care support-including antibiotics, vasopressors, mechanical ventilation, plasma exchange, and continuous renal replacement therapy-the patient survived, exhibiting complex ischemic sequelae that secondary cutaneous necrosis necessitated multi-stage surgical autologous grafting, which subsequently resulted in long-term functional extremity deficits.Conclusion
This case underscores the hyperacute progression of serogroup B meningococcemia in an adolescent previously immunized against serogroups A and C. The clinical course illustrates an individual vulnerability under the current polysaccharide-based framework and highlights the public health relevance of reassessing regional vaccine strategies and enhancing surveillance for emerging serogroups.
Related
- Machine learning-based typing of Salmonella enterica O-serogroups by the Fourier-Transform Infrared (FTIR) Spectroscopy-based IR Biotyper system
- Pathogenicity and Comparative Genomics Analysis: Pasteurella multocida Serogroups A and F Isolated from Domestic Rabbits in China.
- Evaluation of the Leptocheck-WB IgM Rapid Test for Acute Leptospirosis Among Acute Undifferentiated Fever Patients in Hoima, Western Uganda: Very Low Sensitivity in a Setting Where Non-Icterohaemorrhagiae Leptospira Serogroups Predominate.
- Single-cell-resolved dynamic immune remodeling following Omicron infection and recovery in vaccinated individuals
- Identification of a pan-orthoebolavirus-reactive antibody from an rVSV-EBOV vaccinated individual
BibTeX
@article{hu2026fulminant,
title = {{Fulminant serogroup B meningococcemia in an adolescent vaccinated against serogroups A and C: highlighting the serogroup B vaccination gap in China-a case report and literature review.}},
author = {Qifa Hu and Jun Jiang and Haixia Zhu and Zhenzhu Yao and Shanghong Tang and Hongxing Li and Weipeng Feng and Xuefei Zeng and Xiuling Huang and Hailing Huang and Dan Zhang},
journal = {Frontiers in medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.1818444},
url = {https://europepmc.org/article/MED/42923406},
note = {CC BY},
}
RIS
TY - JOUR
TI - Fulminant serogroup B meningococcemia in an adolescent vaccinated against serogroups A and C: highlighting the serogroup B vaccination gap in China-a case report and literature review.
AU - Qifa Hu
AU - Jun Jiang
AU - Haixia Zhu
AU - Zhenzhu Yao
AU - Shanghong Tang
AU - Hongxing Li
AU - Weipeng Feng
AU - Xuefei Zeng
AU - Xiuling Huang
AU - Hailing Huang
AU - Dan Zhang
PY - 2026
DA - 2026/10/07
JO - Frontiers in medicine
DO - 10.3389/fmed.2026.1818444
UR - https://europepmc.org/article/MED/42923406
AB - Background Invasive meningococcal disease (IMD) remains an acute clinical challenge associated with high mortality and permanent disability. Although routine immunization has successfully suppressed historical lineages, an expanding epidemiological shift toward serogroup B in specific regions has exposed a population vulnerability, given that protein-based serogroup B vaccines are excluded from China's National Immunization Program (NIP, historically referred to as EPI). We present a case that characterizes the clinical trajectory of this vaccination mismatch.Case presentation We report a case of a 12-year-old boy from Guangdong Province, China, who had previously received vaccination against Neisseria meningitidis serogroups A and C. He presented with fever and a rapidly progressive purpuric rash. Within hours, his condition deteriorated to septic shock, disseminated intravascular coagulation (DIC), and multiple organ dysfunction syndrome (MODS), consistent with purpura fulminans. Blood cultures confirmed N. meningitidis serogroup B. Following aggressive intensive care support-including antibiotics, vasopressors, mechanical ventilation, plasma exchange, and continuous renal replacement therapy-the patient survived, exhibiting complex ischemic sequelae that secondary cutaneous necrosis necessitated multi-stage surgical autologous grafting, which subsequently resulted in long-term functional extremity deficits.Conclusion This case underscores the hyperacute progression of serogroup B meningococcemia in an adolescent previously immunized against serogroups A and C. The clinical course illustrates an individual vulnerability under the current polysaccharide-based framework and highlights the public health relevance of reassessing regional vaccine strategies and enhancing surveillance for emerging serogroups.
SN - 2296-858X
ER -