Primary Meningococcal Pneumonia Diagnosed by Pleural Fluid Culture

Sir.—Primary pneumonia due to Neisseria meningitidis is infrequently reported in the pediatric population. The diagnosis is difficult because of the inability of children to expectorate adequate sputum specimens. Of the pediatric patients described in the recent literature, two were adolescents who had meningococci isolated from expectorated sputum,^1,2 and two were infants with alveolar infiltrates on chest roentgenograms and blood cultures that yielded the organism.³I recently saw in consultation a child who had group B meningococcal pneumonia, with the organism isolated from a small pleural effusion.

Patient Report.—The patient was a previously healthy 4⅓-year-old boy with a three-week history of upper respiratory tract infection symptoms and a nonproductive cough. He presented to the emergency room with fever and tachypnea. His medical history was noncontributory. A physical examination showed a tired and pale youngster with a temperature of 38.2 °C, a pulse rate of 120 beats per