Meningococcal chest infections in a general hospital

In the course of one calendar year (1989-1990), 46 specimens of respiratory secretions (from 44 patients) cultured in the microbiology department of a large district general hospital in The Netherlands were found to yield Neisseria meningitidis. Twenty-eight of the 46 samples yielded pure cultures of meningococci and 18 yielded other recognised respiratory pathogens as well. Only one patient had pneumonia, whereas 19 had acute respiratory infections and 18 acute purulent exacerbations of chronic bronchitis. The remaining patients, who had a variety of symptoms, all had purulent sputum. Only 8 of the 44 patients were under 40 years of age; 21 were aged more than 60 years. Serological grouping and subtyping showed a predominance of group B strains (in 24 of 44 patients) and 13 strains were non-groupable. The importance of recognising or overlooking meningococci in cultures of respiratory secretions is discussed.