BMJ Case Reports 2012; doi:10.1136/bcr.11.2011.5095
  • Unusual association of diseases/symptoms

A complicated simple fall – an atypical case of serogroup Y meningococcal pneumonia with secondary septicaemia and literature review

  1. TS Purewal
  1. Department of Endocrinology and General Medicine, Royal Liverpool University Hospital, Liverpool, UK
  1. Correspondence to Dr BKY Chan, benjaminchan{at}


An elderly lady was admitted for pain management and rehabilitation following a fall. During her stay she developed a new heart murmur and sepsis. Subacute bacterial endocarditits was excluded, empirical ciprofloxacin was initiated and later converted to aztreonam with gentamicin for clinical deterioration. Subsequent investigations revealed meningococcal Y septicaemia secondary to pneumonia, with a possible oropharynx focus. Upon discharge she had returned to baseline state. The case reflects an unusual and increasing cause of pneumonia. A steady increase of infective serogroup Y isolates over the past 12-years in England, with tendency towards elderly makes it a significant differential among the general medical population. This trend corresponds with the US, but is yet unknown whether to be a periodic cycle or true change in dominance and, or, virulence among serogroups. If the latter were true, it would support the inclusion of serogroups beyond menigitides C in the vaccination program.


  • Competing interests None.

  • Patient consent Obtained.

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