Abstract Introduction Neisseria meningitidis is a gram-negative diplococcus that can cause meningococcal disease. Typically it presents as meningitis and meningococcemia affecting people of all ages. It is vital to promptly identify patients with meningococcal illness so treatment can be initiated and those in close contact with the patient can receive prophylactic treatment. Although rare, it can also be associated with septic arthritis, urethritis, pericarditis, and pneumonia which is how our patient presented. Case Presentation 60 year old male who presented to Pulmonary clinic for evaluation of abnormal lung cancer screening. Patient was asymptomatic with no dyspnea, cough, fever, chills, and weight loss with a 90 pack-year smoking history and family history significant for lung cancer in his father. On CT chest there was precarinal lymph node enlargement of 17x23 mm, 13x13 mm spiculated nodule to the right upper lung, and a 5 mm nodule to the right lower lung. Following this, the patient underwent robotic navigational bronchoscopy with pathology results negative for malignancy, but showing benign respiratory epithelium with features of vague granuloma formation. Respiratory cultures obtained were positive for Neisseria Meningitidis so he was started on a course of ciprofloxacin. Following treatment he remained asymptomatic and was evaluated by Infectious disease. Conclusion Meningococcal pneumonia is uncommon despite up to 10% of the general population carrying the bacteria in their nose and throat without impacting their health. Typically look for symptoms such as fever, chills, cough, pleuritic chest pain, and dyspnea. Even though this is a reportable illness to the Department of Health, there are no clear guidelines for post exposure prophylaxis treatment for meningococcal pneumonia, while ciprofloxacin is preferred prophylaxis for meningitis exposure. Various viral respiratory infections such as influenza have been linked to meningococcal pneumonia. The diagnosis of meningococcal pneumonia is confirmed by isolating the organism either in sputum or cultures. There is limited data guiding antibiotic treatment of non meningitis infections, but ceftriaxone, penicillin, and fluoroquinolones are commonly used. In conclusion, meningococcal pneumonia is rather uncommon and requires prompt identification for management. This abstract is funded by: None
O’Keefe et al. (Fri,) studied this question.