Beyond the Central Nervous System: Neisseria meningitidis as an Unusual Cause of Urogenital Infection

Neisseria meningitidis is a well-known cause of invasive diseases such as meningitis and septicemia, but is increasingly recognized as an emerging urogenital pathogen. We report the case of a 36-year-old man who presented to a tertiary hospital in Riyadh, Saudi Arabia, with persistent dysuria and purulent urethral discharge. Despite initial treatment for nonspecific urethritis and subsequent management for chronic prostatitis with levofloxacin and azithromycin, his symptoms persisted. Although standard multiplex polymerase chain reaction (PCR) assays for common sexually transmitted infections were negative, specialized culture on Thayer-Martin medium followed by VITEK (bioMérieux, France) mass spectrometry identified N. meningitidis. This case highlights the diagnostic challenges associated with meningococcal urogenital infections, which can mimic gonorrhea yet evade detection by routine molecular sexually transmitted infection panels.