Ewha Med J.  2014 Sep;37(2):109-111. 10.12771/emj.2014.37.2.109.

Acute Bacterial Meningitis Caused by Neisseria cinerea

• Lee KE
• Son HM
• Lee M
• Choi HJ

• KMID: 2171292
• DOI: http://doi.org/10.12771/emj.2014.37.2.109

Abstract

Neisseria cinerea is an oropharyngeal normal flora known as a non-pathogenic gram-negative diplococcus. Encephalo-meningitis related to N. cinerea is very rare. A 15-year-old healthy male visited emergency room for altered mentality with fever, headache, and vomiting. Physical examination showed abdominal tenderness and neck stiffness but there was no skin rash. Cerebrospinal fluid (CSF) examination revealed opening pressure of 210 mmH2O, red blood cell 200/mm3, white blood cell 8,320/mm3, neutrophil 84%, glucose 34 mg/dL, suggesting acute bacterial meningitis. Empirical antibiotics were administered and N. cinerea was identified in CSF culture. The patient showed complete recovery 10 days after administration of ceftriaxone. We report this case as the first N. cinerea meningitis in Korea.

Keyword

Neisseria cinerea; Meningitis

MeSH Terms

Adolescent
Anti-Bacterial Agents
Ceftriaxone
Cerebrospinal Fluid
Emergency Service, Hospital
Erythrocytes
Exanthema
Fever
Glucose
Headache
Humans
Korea
Leukocytes
Male
Meningitis
Meningitis, Bacterial*
Neck
Neisseria cinerea*
Neutrophils
Physical Examination
Vomiting
Anti-Bacterial Agents
Ceftriaxone
Glucose

Reference

1. Knapp JS, Hook EW 3rd. Prevalence and persistence of Neisseria cinerea and other Neisseria spp. in adults. J Clin Microbiol. 1988; 26:896–900.

2. Kirchgesner V, Plesiat P, Dupont MJ, Estavoyer JM, Guibourdenche M, Riou JY, et al. Meningitis and septicemia due to Neisseria cinerea. Clin Infect Dis. 1995; 21:1351.

3. Boyce JM, Taylor MR, Mitchell EB Jr, Knapp JS. Nosocomial pneumonia caused by a glucose-metabolizing strain of Neisseria cinerea. J Clin Microbiol. 1985; 21:1–3.

4. Dossett JH, Appelbaum PC, Knapp JS, Totten PA. Proctitis associated with Neisseria cinerea misidentified as Neisseria gonorrhoeae in a child. J Clin Microbiol. 1985; 21:575–577.

5. Clausen CR, Knapp JS, Totten PA. Lymphadenitis due to Neisseria cinerea. Lancet. 1984; 1:908.

6. van de Beek D, de Gans J, Tunkel AR, Wijdicks EF. Community-acquired bacterial meningitis in adults. N Engl J Med. 2006; 354:44–53.

7. van de Beek D, de Gans J, Spanjaard L, Weisfelt M, Reitsma JB, Vermeulen M. Clinical features and prognostic factors in adults with bacterial meningitis. N Engl J Med. 2004; 351:1849–1859.

8. Schuchat A, Robinson K, Wenger JD, Harrison LH, Farley M, Reingold AL, et al. Bacterial meningitis in the United States in 1995. N Engl J Med. 1997; 337:970–976.

9. Lee JH, Cho HK, Kim KH, Kim CH, Kim DS, Kim KN, et al. Etiology of invasive bacterial infections in immunocompetent children in Korea (1996-2005): a retrospective multicenter study. J Korean Med Sci. 2011; 26:174–183.

10. Scarborough M, Thwaites GE. The diagnosis and management of acute bacterial meningitis in resource-poor settings. Lancet Neurol. 2008; 7:637–648.

11. Kim HS, Heo ST, Bae IG, Lim MH, Kim JH, Yun SE, et al. A case of acute bacterial meningitis caused by Vibrio vulnificus. Korean J Med. 2010; 78:523–526.

12. van Crevel H, Hijdra A, de Gans J. Lumbar puncture and the risk of herniation: when should we first perform CT? J Neurol. 2002; 249:129–137.

13. Hasbun R, Abrahams J, Jekel J, Quagliarello VJ. Computed tomography of the head before lumbar puncture in adults with suspected meningitis. N Engl J Med. 2001; 345:1727–1733.

14. Coureuil M, Join-Lambert O, Lecuyer H, Bourdoulous S, Marullo S, Nassif X. Mechanism of meningeal invasion by Neisseria meningitidis. Virulence. 2012; 3:164–172.

15. Sigurdardottir B, Bjornsson OM, Jonsdottir KE, Erlendsdottir H, Gudmundsson S. Acute bacterial meningitis in adults: a 20-year overview. Arch Intern Med. 1997; 157:425–430.