Meningococcal pneumonia: a review

Abstract

Background Although Neisseria meningitidis is one of the major causes of meningitis, meningococcal pneumonia is the most common non-neurological organ disease caused by this pathogen. Methods We conducted a review of the literature to describe the risk factors, pathogenesis, clinical features, diagnosis, treatment and prevention of meningococcal pneumonia. Results Meningococcal pneumonia was first described in 1907 and during the 1918–1919 influenza pandemic large numbers of cases of meningococcal pneumonia occurred in patients following the initial viral infection. A number of publications, mainly case series or case reports, has subsequently appeared in the literature. Meningococcal pneumonia occurs mainly with serogroups Y, W-135 and B. Risk factors for meningococcal pneumonia have not been well characterised, but appear to include older age, smoking, people living in close contact (e.g. military recruits and students at university), preceding viral and bacterial infections, haematological malignancies, chronic respiratory conditions and various other non-communicable and primary and secondary immunodeficiency diseases. Primary meningococcal pneumonia occurs in 5–10% of patients with meningococcal infection and is indistinguishable clinically from pneumonia caused by other common pathogens. Fever, chills and pleuritic chest pain are the most common symptoms, occurring in > 50% of cases. Productive sputum and dyspnoea are less common. Diagnosis of meningococcal pneumonia may be made by the isolation of the organism in sputum, blood, or normally sterile site cultures, but is likely to underestimate the frequency of meningococcal pneumonia. If validated, PCR-based techniques may be of value for diagnosis in the future. While penicillin was the treatment of choice for meningococcal infection, including pneumonia, prior to 1991, a third generation cephalosporin has been more commonly used thereafter, because of concerns of penicillin resistance. Chemoprophylaxis, using one of a number of antibiotics, has been recommended for close contacts of patients with meningococcal meningitis, and similar benefits may be seen in contacts of patients with meningococcal pneumonia. Effective vaccines are available for the prevention of infection with certain meningococcal serogroups, but this field is still evolving. Conclusion Meningococcal pneumonia occurs fairly frequently and should be considered as a possible cause of pneumonia, particularly in patients with specific risk factors.

Conformational changes of DNA repair glycosylase MutM triggered by DNA binding

“…Neisseria meningitidis is a human pathogenic bacterium responsible for bacterial meningitis, septicemia and meningococcal pneumonia and is characterized by a relatively high fatality rate, but its natural habitat is restricted to the vicinity of the human larynx [34,35]. Due to its pathogenic character and restricted habitat, its small genome contains only a handful of DNA repair genes with one Fpg/Nei glycosylase [36,37].…”

Evaluation of Extraction Methods for Clinical Metagenomic Assay

“…Sequence analysis of her throat swab showed two viruses: an RNA virus, Respiratory syncytial virus with 845 f, and a DNA virus, Human betaherpesvirus 5 (Cytomegalovirus) with 809 f. A number of pathogenic bacteria were also detected: Streptococcus pneumoniae (11 f), Moraxella catarrhalis (309 f), and Dolosigranulum pigrum with a maximum frequency of 12,087. Neisseria meningitidi, which is the most common non-neurological pathogen that causes pneumonia [22], was found in the sample with 10 f. In addition, Streptococcus mitis (1218 f), Streptococcus pseudopneumoniae (16 f), and Corynebacterium pseudodiphtheriticum (306 f) were found.…”

Recent changes of invasive meningococcal disease in France: arguments to revise the vaccination strategy in view of those of other countries

“…29 Such strategy might also decrease incidence of IMDCWY in adults from middle age, thanks to the durability of the immunogenicity at individual level and also to a herd effect (at least for C and Y). In elderly IMDY needs more attention, particularly because it is frequently observed as invasive pneumonia [30][31][32] implying that its burden may be underestimated.…”