Fulminating Meningitis with Waterhouse-Friderichsen Syndrome Due toNeisseria gonorrhoeae

Abstract

A three-monthold Caucasian girl was admitted 2½ hr. before death with a diagnosis of upper respiratory infection and with hemorrhagic areas over the face and extremities. Direct smears from spinal fluid removed at autopsy contained many intracellular Gram-negative diplococci. Neisseria gonorrhoeae was obtained after cultivation for 24 hr. Both direct and delayed fluorescent tests for Neisseria gonorrhoeae were positive. In addition, the oxidase test was positive, and fermentation reactions gave the following reactions: lactose, negative; sucrose, negative; maltose, negative; and dextrose, positive. Although gonorrheal meningitis is rare, the organism can produce a clinical picture similar to that resulting from Neisseria meningitidis.