A Pediatric Case of Serogroup Y Meningococcal Meningitis in a 12-Year-Old Boy Combined with Respiratory Infection of Three Species of Viruses in China

Xuemei Li,1,* Yinfang Shen,2,* Yue Jiang,3 Panpan Lv,4 Baixing Ding,5,6 Mingliang Chen3,4 1Department of Infectious Diseases, The First Hospital of Mile in Yunnan Province, Yunnan, People’s Republic of China; 2Department of Pediatrics, Meilong Community Health Center of Minhang District, Shanghai, People’s Republic of China; 3Department of Research and Translational Laboratory of Acute Injury and Secondary Infection, Minhang Hospital, Fudan University, Shanghai, People’s Republic of China; 4Department of Laboratory Medicine, Minhang Hospital, Fudan University, Shanghai, People’s Republic of China; 5Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China; 6Key Laboratory of Clinical Pharmacology of Antibiotics, Ministry of Health, Shanghai, People’s Republic of China*These authors contributed equally to this workCorrespondence: Mingliang Chen, Department of Research and Translational Laboratory of Acute Injury and Secondary Infection, Minhang Hospital, Fudan University, 170 Xinsong Road, Shanghai, 201199, People’s Republic of China, Email [email protected]: Serogroup Y (MenY) invasive meningococcal disease (IMD) is uncommon in China, and MenY IMD cases combined with respiratory infections caused by several viruses are rare worldwide.Case Presentation: A 12‑year‑old boy was admitted by ambulance to a secondary hospital in Yunnan on January 9, 2025, due to sore throat for three days, fever, headache, and vomiting for six hours. Neisseria meningitidis (Nm) was cultured from the cerebrospinal fluid, whereas influenza A virus, adenovirus, and rhinovirus were detected in throat swab by PCR. After treatment with ceftriaxone and oseltamivir, the patient’s condition improved and was discharged. Whole-genome sequence analysis of the Nm isolate (Nm534) showed a molecular type of Y: P1.5– 1,10-1: F4-1: ST-1655(CC23) without antimicrobial resistance-associated mutations. Phylogenetic analysis indicated that Nm534 was assigned to Clade II and was closely related to isolates from Guangdong and Guangxi, which have the potential to be the infection source of this IMD case.Conclusion: A rare case of MenY meningococcal meningitis combined with respiratory infection caused by three species of viruses was reported in China. It is recommended that school-aged children and adolescents be immunized with meningococcal polysaccharide conjugate vaccine ACYW.Keywords: Neisseria meningitidis, serogroup Y, invasive meningococcal disease, virus infection, whole genome sequencing