Neisseria cinerea bacteremia in a patient receiving eculizumab: a case report

Abstract

Neisseria cinerea is a commensal species capable of colonizing the upper respiratory tract of humans. Bacteremia associated with this organism is very uncommon, with only seven previous cases described. We report a case of Neisseria cinerea bacteremia in a patient maintained on indefinite eculizumab therapy. It is the eighth reported case of Neisseria cinerea bacteremia and represents the first case in a patient receiving eculizumab.

Unusual Neisseria species as a cause of infection in patients taking eculizumab

“…A total of seven cases were included in the series, including the FAERS case also reported in the literature. [20] Among the seven cases in the series, five Neisseria spp. were noted as a cause of disease, including N. sicca/subflava (cases 1 and 2), N. sicca (case 3), N. cinerea (cases 4 and 5), N. mucosa (case 6), and N. flavescens (case 7) ( Table 2).…”

“…The FAERS search identified 10 reports of interest, including one FAERS case also reported in the literature (described above, [20]). No additional case reports were identified in the literature.…”

“…However, reports of disease caused by other Neisseria spp. in eculizumab recipients are uncommon: the first case report, published in 2018, describes a bloodstream infection caused by N. cinerea [20]. Thus, there is a need to characterize the spectrum of disease caused by unusual Neisseria spp.…”

Neisseria cinerea in a Post-splenectomy Patient: A Rare Potentially Fatal Bacteremia

“…Amino acids like cysteine, cystine, proline and arginine are required for its growth. Unlike Neisseria gonorrhea, N. cinerea can grow on mediums like Mueller-Hinton agar and trypticase soy agar, and is not resistant to colistin [ 4 ].…”

“…As described earlier, Neisseria cinerea normally colonizes human oropharynx but very rarely enters the bloodstream. All the cases of N. cinerea bacteremia reported to date are described in Table 1 [ 1 , 4 - 9 ].…”