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Published on: November 5, 2019
[Neisseria meningitidis urethritis: Two case reports]
C Dubois1, A-L Liegeon1, C Fabbro2
1Service de dermatologie, CHR Metz Thionville, 1-3, rue du Friscaty, 57100 Thionville, France.
Background:
Neisseria meningitidis (NM) is a commensal bacteria present in the oropharyngeal flora that causes invasive infections. There have been rarer reports of presence in the genital region. Herein, we present two cases of acute NM urethritis.
Patients And Methods:
Two men aged 30 and 31years, one of whom is homosexual and seropositive for HIV infection, presented urethral discharge which was diagnosed as acute urethritis. The unit through samples indicated the presence of NM of serogroups B and C. One of the antibiotic sensitivity tests revealed intermediate susceptibility to penicillin G and to amoxicillin.
Discussion:
The clinical presentation of acute NM urethritis is non-specific, because of which urethral samples should be taken wherever acute urethritis is suspected. NM urethritis is infrequent and primarily affects men who have sex with men (MSM). Its current increase is due to unprotected oral-genital sexual practices. Due to the emergence of resistance to NM, antibiotic susceptibility testing should be carried out routinely to ensure appropriate therapy and prophylaxis. Cases of invasive serogroup C meningococcal infections have been recorded within the MSM population with hypothetical sexual port of entry. Thus, the French High Public Health Authority recommends vaccination against meningitis C in this population.
Insights
Neisseria meningitidis (NM) can cause acute urethritis, particularly in men who have sex with men (MSM), often linked to sexual practices. Routine antibiotic susceptibility testing and vaccination are crucial due to emerging resistance and invasive infections.
Area of Science:
- Urology
- Infectious Diseases
- Microbiology
Background:
- Neisseria meningitidis (NM), a common bacterium, typically resides in the throat but can cause invasive infections.
- Reports of NM in the genital tract are rare, with this study focusing on urethritis cases.
Observation:
- Two cases of acute urethritis caused by NM (serogroups B and C) were observed in adult men.
- One patient was homosexual and HIV-positive, presenting with urethral discharge.
Findings:
- Antibiotic susceptibility testing showed intermediate resistance to penicillin G and amoxicillin in one case.
- The clinical presentation of NM urethritis is non-specific, necessitating urethral sampling for diagnosis.
Implications:
- NM urethritis is infrequent but increasing among men who have sex with men (MSM) due to sexual practices.
- Routine antibiotic susceptibility testing is vital for effective treatment and prophylaxis against NM.
- Vaccination against meningitis C is recommended for the MSM population due to invasive serogroup C infections.
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