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Neisseria meningitidis: a cause of nosocomial pneumonia
Abstract:
A 24-year-old man developed coma and many neurologic abnormalities for 2 weeks after ingesting phencyclidine. On admission, pulmonary aspiration occurred, for which he was given large doses of methylprednisolone, clindamycin, and gentamicin. These antimicrobial drugs were continued for 2 weeks until new pulmonary infiltrates were recognized. Neisseria meningitidis was subsequently isolated from cultures of conjunctival discharge, sputum, and blood and found to be resistant to clindamycin and gentamicin. N. meningitidis as a cause of nosocomial pneumonia in the setting of broad spectrum antimicrobial drugs is discussed.
Insights
A young man developed severe neurological issues and pneumonia after phencyclidine use. The pneumonia was caused by drug-resistant Neisseria meningitidis, highlighting a rare nosocomial infection risk.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Clinical Toxicology
Background:
- Phencyclidine (PCP) abuse can lead to severe neurological complications.
- Pulmonary aspiration is a known risk in patients with altered mental status.
- Broad-spectrum antibiotics are often used empirically in critically ill patients.
Purpose of the Study:
- To report a rare case of nosocomial pneumonia caused by Neisseria meningitidis.
- To investigate the role of prior antibiotic treatment in the development of resistant infections.
- To discuss the implications for managing PCP-intoxicated patients with secondary infections.
Main Methods:
- Case report of a 24-year-old male with phencyclidine intoxication.
- Clinical monitoring for neurological and respiratory complications.
- Microbiological cultures (conjunctiva, sputum, blood) and antimicrobial susceptibility testing.
Main Results:
- Patient presented with coma and neurological deficits after phencyclidine ingestion.
- Developed hospital-acquired pneumonia despite broad-spectrum antibiotic therapy (methylprednisolone, clindamycin, gentamicin).
- Neisseria meningitidis, resistant to clindamycin and gentamicin, was isolated from multiple sites.
Conclusions:
- Neisseria meningitidis can cause nosocomial pneumonia in immunocompromised or critically ill patients.
- Prolonged broad-spectrum antibiotic use may contribute to the emergence of resistant pathogens.
- Vigilance for unusual pathogens is crucial in patients with complex medical histories and prolonged hospital stays.