Neisseria meningitidis bacteraemia and lobar pneumonia in a previously healthy, fully immunised (including meningococcal vaccines) Irish teenager.

An adolescent female patient presented to the Emergency Department of a large tertiary hospital in Ireland, with a 1-day history of chest and left axillary pain, and a 5-day history of productive cough, fever, reduced oral intake and lethargy; no previous medical history, sick contacts or recent travel. Vaccinations were up to date. Symptomatology, raised inflammatory markers, radiographic findings, coupled with relevant auscultatory findings, led to a diagnosis of community-acquired pneumonia. Less than 24 hours after presentation, Neisseria meningitidis was isolated from a blood culture, prompting patient isolation and commencement of high-dose ceftriaxone. Close contacts received prophylaxis, and public health authorities were notified. Meningococcal pneumonia, although infrequently seen in adults, has been reported in the paediatric population to date only rarely. This case serves as a reminder that meningococcal disease is notifiable, requiring prompt reporting to public health authorities, patient isolation and prophylaxis for close contacts. It also highlights meningococcal pneumonia as a cause of paediatric pneumonia, even in fully vaccinated, immunocompetent children, and the importance of obtaining blood samples for culture before commencing antibiotic therapy to maximise microbiological confirmation.