Unusual presentation of meningococcal infection

Infection with Neisseria meningitidis usually results in life-threatening septicemia and/or meningitis. Occasionally, howerver, infection may be mild or localized. Awareness of this fact is essential to avoid delays in diagnosis, management and prophylaxis. Three cases are presented with localized or mild presentation. A 40-day-old male with purulent conjunctivitis, a six-year-old male with peritonitis and a nine-year-old with C5 deficiency with Neisseria meningitidis bacteremia who presented with a one day history of fever, but was not toxic, and was treated with oral antibiotics. However, he returned with a clinical picture of systemic infection. Based on these three cases, we suggest an aggressive diagnostic, therapeutic and prophylactic approach whenever meningococcal infection is strongly suspected.