Disseminated meningococcal infection in HIV-seropositive patients.

ABSTRACT

OBJECTIVE: Although increasing numbers of infections due to various bacterial pathogens have been described in HIV-infected individuals, there have been few reports to date of disseminated Neisseria meningitidis infections in such individuals. We describe here the presentation and clinical course of systemic meningococcal infection in two HIV-1-seropositive men and the response to meningococcal vaccine in one. DESIGN AND METHODS: Retrospective analysis of case reports of two patients identified in a municipal hospital in Denver, Colorado, USA, and evaluation by enzyme-linked immunosorbent assay of antibody response to quadrivalent (A, C, Y, W-135) meningococcal vaccine. RESULTS: A 27-year-old HIV-seropositive man with bacteremic group Y meningococcal pneumonia and a 45-year-old man with AIDS and group B meningococcal arthritis both responded to short-term antibiotic therapy without recurrence. The second patient responded to meningococcal vaccination with seroconversion to all four serogroups. CONCLUSIONS: Disseminated meningococcal infection, although rare in HIV-infected individuals, may present with a variety of clinical manifestations and responds well to antibiotic therapy. Meningococcal vaccine appears to be immunogenic in such individuals.