Meningococcal meningitis presenting postinfant group B meningococcal immunisation

We report an infant case of meningococcal group W meningitis presenting within 24 hours of receiving group B meningococcal vaccine (4CMenB), illustrating the dilemma clinicians face in interpreting advice for management of post-immunisation fever and the National Institute for Health and Care Excellence (NICE) fever guidelines, and highlighting the need for sustained vigilance for bacterial infections in infants with post-4CMenB fever. A 2-month-old girl arrived by ambulance to the local emergency department in April 2017 suffering from right-sided focal limb seizures and fever of 39°C, within 24 hours of receiving her 2-month immunisations (including 4CMenB). The seizure terminated with two doses of intravenous lorazepam and suspected sepsis was treated with immediate intravenous antibiotics. Investigations revealed a normal cranial CT scan; elevated C-reactive protein (263.5 mg/L (0–5 mg/L)); normal full blood count; normal liver …