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Case Reports in Nephrology
Volume 2011 (2011), Article ID 274341, 3 pages
http://dx.doi.org/10.1155/2011/274341
Case Report

Bilateral Renal Cortical Necrosis in Meningococcal Meningitis

1Department of Nephrology, Beaumont Hospital, Dublin 9, Ireland
2Department of Pathology, Beaumont Hospital, Dublin 9, Ireland

Received 27 July 2011; Accepted 27 September 2011

Academic Editors: Y.-L. Chiu, R. Enríquez, A. Papagianni, and A. K. Saxena

Copyright © 2011 C. Kennedy et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Bacterial meningitis is a relatively common infection of the cerebrospinal fluid (CSF) and leptomeninges. The clinical picture evolves rapidly and, if treatment is delayed, can result in a variety of long-term sequelae, including death. Acute kidney injury in the setting of bacterial meningitis usually results from hypotension and volume depletion and resolves with appropriate treatment. Meningococcaemia with profound hypotension, and/or disseminated intravascular coagulopathy (DIC) may very rarely lead to bilateral renal cortical necrosis. In this context, renal recovery is extremely unlikely. We present two cases of meningococcaemia complicated by bilateral renal cortical necrosis and, ultimately, end stage kidney disease. We also present a review of the literature on the subject. The cases outline the importance of early aggressive intervention by a multidisciplinary team.