Primary meningococcal pneumonia in elderly patients

Neisseria meningitidis infection in humans usually manifests as meningitis and septicemia with skin manifestations. Infections of the respiratory trac t with N meningitidis have been documented in the past, but often this orga nism is not routinely considered in the differential diagnosis of pneumonia . The pathogenic role of N meningitidis in lower respiratory tract infectio ns may be underestimated because its isolation is difficult, particularly w hen oropharyngeal flora are present. We profile 2 elderly patients with pri mary meningococcal pneumonia to show the importance of Gram stain and cultu re in early diagnosis. These modalities helped guide treatment and prophyla ctic measures.