Abstract
An 89 year-old Japanese woman with no history of contact with infected patients developed meningococcal meningitis with meningococcemia. Invasive meningococcal disease is relatively rare in Japan compared to other countries. The annual incidence has been a total of 10-20 cases per year for more than two decades, representing approximately 1% of the number in the United States and United Kingdom. The most prevalent serotypes in Japan are serotypes B and Y. This patient's strain was serotype Y. The meningococcal vaccine has not yet been approved for use in Japan. The only possible transmission route for this patient was a visit by her grandchild a few days prior to the onset of symptoms. Due to its low incidence, clinicians do not have sufficient experience to manage this potentially fatal illness. This case serves as an important reminder to always consider a complete differential diagnosis for invasive meningococcal disease.
