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Neisseria meningitidis (meningococci) is the most common cause of bacterial meningitis in all age groups. Invasive meningococcal disease manifesting as meningococcal pneumonia is a very rare clinical condition. Here we have a 72 year old male who presented with meningococcal pneumonia and sepsis following a flu like illness. It is notable that he did not develop the syndrome of meningococcemia or its associated complications. This patient was treated with injections of Piperacillin-Tazobactum and Azithromycin because of the unusual antibiotic resistance pattern of the organism. He recovered completely without any sequelae. The meningococci isolated was an ESBL (extended spectrum beta lactamase) producing strain, hence it was resistant to Penicillin and third generation Cephalosporins which are usually used for the treatment of meningococcal infections .This strain was also resistant to Ciprofloxacin .This poses a threat to the community as well, especially because Ciprofloxacin is used as a chemo prophylactic drug by the contacts of the patient and the laboratory workers dealing with the patient’s clinical samples.

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