Variation in phenotypic expression of the Opa outer membrane protein and lipooligosaccharide of Neisseria meningitidis serogroup C causing periorbital cellulitis and bacteremia.
Expression of the Opa outer membrane protein varies widely among isolates of Neisseria meningitidis; the clinical significance of this variation is unclear. A sialic-acid acceptor is present in the lipooligosaccharide of some strains of Neisseria and has been shown to render Neisseria gonorrhoeae serum-resistant. We report the case of a patient who had an unusual clinical manifestation of infection due to N. meningitidis serogroup C, periorbital cellulitis with concomitant bacteremia. Clinical isolates from the blood and aspirate of the periorbital cellulitis were identical except for the phenotypic expression of the Opa outer membrane protein in the isolate from the periorbital cellulitis and in the lipooligosaccharide phenotype of the sialic-acid acceptor as defined by monoclonal antibodies. We discuss the laboratory and clinical implications of these findings.
Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, Tennessee 38101-0318.
C C
CC
Patrick
G T
GT
Furuta
M
M
Edwards
M
M
Estabrook
M S
MS
Blake
C J
CJ
Baker
D000942:Antigens, Bacterial / Q000032:analysis / Q000276:immunology* / Q000302:isolation & purification; D016470:Bacteremia / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology; D001425:Bacterial Outer Membrane Proteins / Q000032:analysis / Q000276:immunology*; D002444:Cefuroxime / Q000627:therapeutic use; D002481:Cellulitis / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology; D004591:Electrophoresis, Polyacrylamide Gel; D004797:Enzyme-Linked Immunosorbent Assay; D015818:Eye Infections, Bacterial / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology; D005260:Female; D006801:Humans; D015151:Immunoblotting; D016130:Immunophenotyping; D007223:Infant; D008070:Lipopolysaccharides / Q000032:analysis / Q000276:immunology*; D008589:Meningococcal Infections / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology*; D009345:Neisseria meningitidis / Q000145:classification / Q000276:immunology*; D010641:Phenotype; D012703:Serotyping
D000942:Antigens, Bacterial; D001425:Bacterial Outer Membrane Proteins; D008070:Lipopolysaccharides; C023023:lipid-linked oligosaccharides; C090348:Opa protein, Neisseria; D002444:Cefuroxime