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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 MeriComments to Author 
Author affiliation: Author affiliations: University of Helsinki, Helsinki, Finland (L. Starck, S. Meri); Helsinki University Central Hospital, Helsinki (V. Nummi, E. Poikonen, A.-E. Lehtinen, P. Kivelä, N. Friberg, J. Torvikoski, S. Meri); Finnish Institute for Health and Welfare, Helsinki (M. Toropainen)

Main Article

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 mass spectrometry), 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; NA, not applicable; PNH, paroxysmal nocturnal hemoglobinuria; PRBC, 1 unit packed red blood cells.

Main Article

Page created: January 22, 2025
Page updated: February 28, 2025
Page reviewed: February 28, 2025
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