This young girl developed disseminated meningococcus (N. meningitidis) following a bout of meningitis. Histologically there is acute vasculitis, a reaction pattern which can have many etiologies. One must always exclude an infectious cause to the vasculitis as the treatment strategy is obviously very different. The organisms are often tough to see in disseminated Neisseria infections and may require special stains or just a reliance on the history.
Small vessels in the superficial vascular plexus show evidence of damage, including focal necrosis and microthrombi. Scattered neutrophils and extravasated red blood cells are also noted. Close inspection of the vessels reveals small coccal organisms, best highlighted by special stains (not shown).