Acute ST-segment elevation in Neisseria meningitis

Meningitis due to Neisseria meningitidis occurred in a young man. On admiss ion, he was in septic shock and the electrocardiogram revealed convex upwar ds ST-segment elevation in inferior and lateral leads. Rapid and complete n ormalisation of the ECG was observed and the patient had a favourable evolu tion with intensive therapy. The mechanisms of the ECG abnormalities in thi s disease are unclear. In this patient, ST-segment elevation was probably r elated to severe transmural ischaemia or prolonged coronary artery spasm as suggested by increase and decrease of cardiac enzymes and transient echoca rdiographic wall motion abnormalities without pericarditis. However, myocar ditis could not be completely ruled out.