Atypical Presentation of Neisseria meningitidis

Abstract

Neisseria meningitidis is an organism that can cause life-threatening infections of the meninges and blood. We present two patients with atypical presentation of meningococcemia without neurological or dermatological findings, and without evidence of infection on spinal fluid analysis. Both patients attended the Emergency Department with sepsis. The first patient presented with symptoms of a lower respiratory tract infection and had right-sided infiltrates on his chest X-ray, prompting the initial diagnosis of pneumonia. The second patient presented with abdominal pain and loose stools, suggesting gastroenteritis. Both patients' blood cultures came back positive for Neisseria meningitidis. They received intravenous antibiotics and were discharged a week after admission in a stable condition without any complications. This case series highlights that Neisseria meningitidis can present without classical findings and should be considered in the differential diagnosis of respiratory tract infections as well as gastroenteritis in order to provide early treatment and prevent irreversible complications.