[A case of acute bronchitis caused by Neisseria meningitidis associated with HIV infection].

We report the case of a patient with acute bronchitis caused by Neisseria meningitidis associated with HIV infection. A 36-year-old homosexual Japanese man being treated for HIV infection and reporting fever and a productive cough was found in laboratory findings to have elevated C-reactive protein but no leukocytosis. Chest radiography showed no infiltrates in either lung, but a sputum smear yielded large numbers of Gram-negative cocci, including some phagocytized by white blood cells. One day later N. meningitidis was reported to be the predominant isolate from sputum culture. The patient was diagnosed with acute bronchitis caused by N. meningitidis. The strain isolated from this patient was in serogroup B. The sequence type based on multilocus sequence typing was ST-5583, a subtype of ST-32. This strain is resistant to penicillin G in vitro, so we administered tosufloxacin at 600mg b.i.d., which showed excellent efficacy. Because of frequent sex with many men, homosexual contact was suspected as a possible route of infection. Meningococcal infections apart from meningitis rarely are surveyed epidemiologically in Japan, and the frequency of meningococcal infections in general is not clear. Vigilance is needed to identify trends in meningococcal infection, because N. meningitidis can cause acute bronchitis.