Chronic meningococcemia presenting with recurrent painful rash and poly-arthralgia without fever.

Chronic meningococcemia is an uncommon disorder, representing a diagnostic challenge. Classically, this pathology would be considered in young adults with a history of episodes of fever, disseminated cutaneous vasculitis and arthralgia. Exact and rapid diagnosis is often further challenged by the fact that routine microbiological investigations frequently failed to identify incriminated micro-organism, Neisseria meningitidis. Here we present the case of a young man not presenting with the classical triad.

Hypercalcemia, chronic lymphocytic leukemia and multiple myeloma: uncommon association.

A fifty-nine year old woman is admitted with severe hypercalcemia and other metabolic disorders. The buffy coat showed plasmoblasts in association with chronic lymphocytic leukemia cells (CLL). Immunophenotyping revealed different light chains on CLL cells and in plasmoblasts. We discuss the association of hypercalcemia and CLL, its physiopathology and the distinction with Richter's Syndrome. We also review literature descriptions of the uncommon association of CLL and Multiple Myeloma and raise the question of its clonal origin.