A Double Whammy Pneumonia: The First Reported Case of Concurrent Neisseria meningitidis and SARS-CoV-2 Pneumonia

Abstract

Meningococcal pneumonia (MP) is a rare manifestation of meningococcal disease. The MP was first described in 1907 when Neisseria meningitidis (NM) isolates were identified in sputum samples obtained from soldiers with pneumonia. Preceding and concurrent viral infections constitute a major risk for MP. During the 1918-1919 influenza pandemic, a significant increase in MP cases were reported in patients with preceding influenza infection. Despite the end of the last H1N1 influenza pandemic in 2010, seasonal influenza infections still pose a risk for simultaneous MP. History appears to be repeating itself with concomitant bacterial and viral coinfection amid the current SARS-CoV-2 pandemic. Herein presented is a unique case of an elderly woman who presented with, to the best of our knowledge, the first reported case of possible concurrent SARS-CoV-2 and MP infections.

Keywords: Neisseria meningitidis; antibiotics; chemoprophylaxis; meningococcal pneumonia; pneumonia.

Image 1.

Chest X-ray at initial presentation demonstrating a 7-cm right upper lobe opacity.

Image 2.

Computed tomography scan at initial presentation, including axial (a) and coronal (b) views, demonstrating large right upper lobe consolidation with air bronchograms, scattered ground-glass opacities, and mediastinal lymph nodes.

Image 3.

Blood culture (a, b) shown at 60× magnification (a) revealing Gram-negative diplococci.

Image 4.

Chest X-ray 3 months after hospital discharge revealing near-complete resolution of previously noted right upper lobe consolidation upon hospital admission.