Neisseria meningitidisW135, Turkey

We describe the first case of Neisseria meningitidis W135 meningitis in Turkey.The strain was genotypically unrelated to the clone (W)ET-37, isolated from Hajj pilgrims in 2000. The CaseA previously healthy 20-year-old serviceman experienced chills, headache, and vomiting 2 days before being admitted to the hospital in March 2003.On physical examination, neck stiffness, Kernig sign, Brudzinski sign, and temperature of 40°C were noted.The patient's cerebrospinal fluid (CSF) was turbid with increased protein and pressure; leukocyte count was 4,500/µL.CSF culture grew Neisseria meningitidis in 24 hours.The strain was serogrouped as W135 by specific antiserum (Difco, Sparks, MD) in Hacettepe Medical School, Turkey, and confirmed by the Centers for Disease Control and Prevention (CDC, Atlanta, GA).Blood culture results were negative, and the patient had no petechial rash.He was treated with high-dose cefotaxime (3 g every 6 hours for 14 days) and made a full recovery.For this isolate, both disk-diffusion and E-test methods using cefotaxime, penicillin, tetracycline, and ciprofloxacin were performed according to the criteria defined by the British Society for Antimicrobial Chemotherapy (1,2).Both methods were performed on Iso-Sensitest agar (Oxoid, Basingstoke, UK), supplemented with 5% defibrinated horse blood and nicotine adenine dinucleotide (Sigma, Taufkrichen, Germany).The isolate was susceptible to all of the antimicrobial agents (Table).The serviceman did not attend the Hajj and had no history of travel or contact with returning pilgrims.