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Volume 31, Number 3—March 2025
Dispatch
Meningococcal Sepsis in Patient with Paroxysmal Nocturnal Hemoglobinuria during Pegcetacoplan Therapy
Leo Starck, Vuokko Nummi, Eira Poikonen, Anna-Elina Lehtinen, Pia Kivelä, Nathalie Friberg, Jukka Torvikoski, Maija Toropainen, and Seppo Meri
Table 2
Case patient diagnostic and hospital course highlights from study of meningococcal sepsis in patient with PNH during pegcetacoplan therapy*
| Treatment day | Microbiology | Treatment | Diagnostic tests and additional treatments |
|---|---|---|---|
| Day 0 | Blood culture | Cefuroxime 1.5 g × 3 | |
| Day 1 | Positive blood culture; Gram staining, challenging interpretation; BCID2 PCR, negative | Cefuroxime 1.5 g × 4 | Pegcetacoplan 1,080 mg; prophylactic enoxaparin started; PRBC transfusion |
| Day 2 | Identification (MALDI-TOF), Neisseria meningitidis; In-house PCR, negative; serogrouping, inconclusive results; preliminary report, nongroupable N. meningitidis | Ceftriaxone 2 g × 2 | PRBC transfusion, contact tracing, prophylactic antimicrobial drugs distributed |
| Day 4 | NA | NA | Brain magnetic resonance imaging (PNH), PRBC transfusion |
| Day 5 | NA | NA | Pegcetacoplan 1,080 mg |
| Day 9 | Whole-genome sequencing, nonencapsulated N. meningitidis harboring capsule null locus | NA | NA |
*Day 0 indicates day patient sought hospital care. BCID2, bioMérieux (https://www.biomerieux.com) Biofire Blood Culture Identification 2 Panel; MALDI-TOF, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry; NA, not applicable; PNH, paroxysmal nocturnal hemoglobinuria; PRBC, 1 unit packed red blood cells.
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Page updated: February 21, 2025
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