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Case report
Meningococcal meningitis and COVID-19 co-infection
  1. Stuart Declan Gallacher1 and
  2. Andrew Seaton2
  1. 1Department of Medical Microbiology, Queen Elizabeth University Hospital, Glasgow, UK
  2. 2Department of of Infectious Diseases, Queen Elizabeth University Hospital, Glasgow, UK
  1. Correspondence to Dr Stuart Declan Gallacher; stuartgallacher{at}


Bacterial co-infection in the ongoing pandemic of COVID-19 is associated with poor outcomes but remains little understood. A 22-year-old woman presented with a 3-week history of fever, headache, neck stiffness, rigours and confusion. She was noted to have a purpuric rash over her hands and feet. Cerebrospinal fluid bacterial PCR was positive for Neisseria meningitidis. A concurrent nasopharyngeal RT-PCR was positive for SARS-CoV-2, the causative virus of COVID-19. She was treated with antibiotics for bacterial meningitis and made a complete recovery. Bacterial infection from nasopharyngeal organisms has followed previous pandemic viral upper respiratory illnesses and the risk of bacterial co-infection in COVID-19 remains unclear. Research characterising COVID-19 should specify the frequency, species and outcome of bacterial co-infection. Management of bacterial co-infection in COVID-19 presents major challenges for antimicrobial stewardship and clinical management. Judicious use of local antibiotic guidelines and early liaison with infection specialists is key.

  • infection (neurology)
  • infectious diseases
  • pneumonia (infectious disease)

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  • Contributors SDG wrote the manuscript and edited drafts with input from AS. AS incepted the study, contributed to writing and editing the manuscript and was involved in the clinical management of the patient.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.