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Invasive meningococcal disease without meningitis: a forgotten diagnosis.
Saqib Walayat1, Nooreen Hussain1, Abdullah H Malik1
1Department of Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, IL, USA.
International Medical Case Reports Journal
|April 27, 2018
Summary
Neisseria meningitidis is a rare cause of pneumonia, with few US cases reported. Early diagnosis and treatment of meningococcal pneumonia are critical due to its high fatality rate.
Area of Science:
- Medicine
- Infectious Diseases
- Pulmonology
Background:
- Neisseria meningitidis, a Gram-negative diplococcus, uncommonly causes pneumonia.
- Reported cases worldwide from 1906-2015: 344.
- Reported cases in the USA in the past two decades: 3.
Observation:
- A 72-year-old male with significant comorbidities including COPD, obstructive sleep apnea, and prior lung cancer treatment presented with symptoms suggestive of pneumonia.
- Diagnostic imaging revealed pneumonia with pleural effusion, and blood cultures confirmed the presence of beta-lactamase-negative N. meningitidis.
Findings:
- The patient received a 14-day course of antibiotics, initially broad-spectrum, then narrowed to amoxicillin.
- Sputum cultures can yield false positives for N. meningitidis due to asymptomatic upper respiratory tract carriage.
Implications:
- Diagnosing meningococcal pneumonia demands a high index of suspicion due to potential diagnostic challenges.
- Prompt recognition and treatment of N. meningitidis pneumonia are crucial, as its case fatality rate may exceed that of meningococcal meningitis.
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