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Background <p>Although <i>Neisseria macacae</i> has been recognized as a commensal of macaque oral flora since 1983, its involvement in human disease remains remarkably uncommon. Prior literature documented fewer than a handful of infections, ranging from reddish rash, bacteremia to invasive conditions such as endocarditis and peritonitis. Strikingly, the respiratory system has not been reported as a site of infection. We first reported a case of pneumonia due to <i>N. macacae</i>.</p> Case presentation <p>A 60-year-old male developed pneumonia during treatment for a cervical spine fracture complicated by spinal cord injury. <i>N. macacae</i> was isolated from sputum culture and identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and 16S rRNA gene sequence analysis. The strain exhibited non-susceptible to third-generation cephalosporins but susceptible to carbapenems. Meropenem was administered, leading to a favorable response and significant improvement after one week, resulting in recovery and discharge 14 days later. No recurrence was observed during a follow-up visit one month post-discharge.</p> Conclusions <p>This case represents the first documented report of <i>N. macacae</i>–associated pneumonia, expanding the known clinical spectrum of this macaque commensal into the human respiratory tract under conditions of impaired clearance. This finding highlights the necessity of enhanced clinical–laboratory collaboration. Furthermore, the strain’s atypical antimicrobial resistance profile underscores the critical importance of comprehensive susceptibility testing to guide targeted therapy and inform empirical treatment strategies in similar clinical scenarios.</p>

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Neisseria macacae pneumonia in a patient with spinal cord injury: a case report

  • 期刊论文

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  • 发表日期：

    2026年5月16日

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  • Junxiang Xia,
  • Qiang Zhang,
  • Yifang Zhu,
  • Lin Deng,
  • Jing Yang,
  • Qin Wang,
  • Jing Zhang,
  • Yizheng Xu

摘要

Background

Although Neisseria macacae has been recognized as a commensal of macaque oral flora since 1983, its involvement in human disease remains remarkably uncommon. Prior literature documented fewer than a handful of infections, ranging from reddish rash, bacteremia to invasive conditions such as endocarditis and peritonitis. Strikingly, the respiratory system has not been reported as a site of infection. We first reported a case of pneumonia due to N. macacae.

Case presentation

A 60-year-old male developed pneumonia during treatment for a cervical spine fracture complicated by spinal cord injury. N. macacae was isolated from sputum culture and identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and 16S rRNA gene sequence analysis. The strain exhibited non-susceptible to third-generation cephalosporins but susceptible to carbapenems. Meropenem was administered, leading to a favorable response and significant improvement after one week, resulting in recovery and discharge 14 days later. No recurrence was observed during a follow-up visit one month post-discharge.

Conclusions

This case represents the first documented report of N. macacae–associated pneumonia, expanding the known clinical spectrum of this macaque commensal into the human respiratory tract under conditions of impaired clearance. This finding highlights the necessity of enhanced clinical–laboratory collaboration. Furthermore, the strain’s atypical antimicrobial resistance profile underscores the critical importance of comprehensive susceptibility testing to guide targeted therapy and inform empirical treatment strategies in similar clinical scenarios.