Related Experiment Videos
Neisseria lactamica meningitis following skull trauma
1Department of Medicine, Santa Clara Valley Medical Center, San Jose, California.
Abstract:
A woman developed meningitis due to Neisseria lactamica in association with a cribriform plate fracture. Cerebrospinal fluid antigen tests for Neisseria meningitidis were negative. The patient recovered with intravenous penicillin therapy. N. lactamica can be rapidly distinguished from N. meningitidis by the hydrolysis of ONPG (o-nitrophenyl-beta-D-galactopyranoside). In contrast to N. meningitidis and Neisseria gonorrhoeae, N. lactamica lacks virulence properties. As 100% of N. lactamica strains are susceptible to penicillin and all three previously described patients with N. lactamica meningitis have recovered with penicillin treatment, the reason for distinguishing the organisms in this context is primarily to prevent unnecessary anxiety and prophylaxis among contacts.
Insights
Neisseria lactamica meningitis, though rare, is treatable with penicillin. Distinguishing it from Neisseria meningitidis prevents unnecessary alarm and contact prophylaxis.
Area of Science:
- Infectious Diseases
- Microbiology
- Neurology
Background:
- Meningitis can arise from various bacterial pathogens, including Neisseria species.
- Cribriform plate fractures present a potential route for pathogen entry into the central nervous system.
Observation:
- A patient presented with meningitis associated with a cribriform plate fracture.
- Cerebrospinal fluid antigen tests for Neisseria meningitidis were negative.
Findings:
- The patient was diagnosed with meningitis caused by Neisseria lactamica.
- Neisseria lactamica was identified and differentiated from Neisseria meningitidis using o-nitrophenyl-beta-D-galactopyranoside hydrolysis.
- The patient successfully recovered following intravenous penicillin therapy.
Implications:
- Neisseria lactamica is distinct from Neisseria meningitidis and Neisseria gonorrhoeae, lacking significant virulence factors.
- All strains of Neisseria lactamica are susceptible to penicillin, making it an effective treatment.
- Accurate differentiation of N. lactamica is crucial to avoid unnecessary anxiety and public health interventions for contacts.