Abstract
Neisseria meningitidis (meningococci) is the most common cause of bacterial meningitis in all age groups. Invasive meningococcal disease manifesting as meningococcal pneumonia is a very rare clinical condition. Here we have a 72 year old male who presented with meningococcal pneumonia and sepsis following a flu like illness. It is notable that he did not develop the syndrome of meningococcemia or its associated complications. This patient was treated with injections of Piperacillin-Tazobactum and Azithromycin because of the unusual antibiotic resistance pattern of the organism. He recovered completely without any sequelae. The meningococci isolated was an ESBL (extended spectrum beta lactamase) producing strain, hence it was resistant to Penicillin and third generation Cephalosporins which are usually used for the treatment of meningococcal infections .This strain was also resistant to Ciprofloxacin .This poses a threat to the community as well, especially because Ciprofloxacin is used as a chemo prophylactic drug by the contacts of the patient and the laboratory workers dealing with the patient’s clinical samples.
Highlights
Neisseria meningitidis is the most common cause of bacterial meningitis in all age groups
Meningococcal pneumonia is a rare clinical condition, but it is the most common non neurological organ disease caused by this pathogen
More than 90 % isolates of Neisseria meningitidis are susceptible to Penicillin
Summary
Neisseria meningitidis (meningococci) is the most common cause of bacterial meningitis in all age groups. Meningococcal pneumonia is a rare clinical condition, but it is the most common non neurological organ disease caused by this pathogen. Meningococcal pneumonia usually affects the elderly (> 65 years). More than 90 % isolates of Neisseria meningitidis are susceptible to Penicillin. In resistant cases third generation Cephalosporins are used, but here we have a case where the organism was resistant to Penicillin, third generation Cephalosporins and Ciprofloxacin. He was nebulized with Levosalbutamol and Ipratropium. The patient’s hematological investigations were done along with chest Xray. His sputum sample and blood samples were sent for Microbiological investigations. Chest X-ray showed right lower zone consolidation and right middle zone pneumonitis (Fig. 1)
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