Meningitis caused by a lipopolysaccharide deficient Neisseria meningitidis

Jurgen R Piet1, Afshin Zariri2, Floris Fransen2

  • 1Department of Neurology, Center of Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, Amsterdam, PO Box 22660, The Netherlands; Department of Medical Microbiology, Center of Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, Amsterdam, PO Box 22660, The Netherlands.

Abstract

Insights

A rare case of meningococcal meningitis was caused by a lipopolysaccharide (LPS)-deficient Neisseria meningitidis strain. This LPS-deficient strain, identified through whole genome sequencing, highlights a novel cause of invasive meningococcal disease.

Area of Science:

  • Microbiology
  • Genetics
  • Infectious Diseases

Background:

  • Lipopolysaccharide (LPS) is a critical outer membrane component of Neisseria meningitidis.
  • Naturally occurring LPS-deficient meningococcal isolates causing clinical disease have not been previously documented.

Observation:

  • A patient presented with thunderclap headache, and the causative Neisseria meningitidis isolate was found to be LPS-deficient.
  • Whole genome sequencing identified a mutation in the lpxH gene as the cause of LPS deficiency.

Findings:

  • The identified lpxH variant impaired growth in E. coli compared to the wild-type.
  • Insertional inactivation of lpxH in N. meningitidis H44/76 also resulted in an LPS-deficient phenotype.

Implications:

  • This study describes the first known case of invasive meningococcal disease caused by a naturally LPS-deficient meningococcal isolate.
  • The findings expand our understanding of meningococcal pathogenesis and the potential for LPS-deficient strains to cause disease.

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