Table 1.

Examples of reported clinical cases of unusual infections with Neisseria species.

Neisseria species	Anatomical Site of Infection	Disease	Case Report
Pathogenic Neisseria species
N. gonorrhoeae 1	Blood	DGI/septicemia	[34,43,44,46,47,48,49]
	Joints	DGI/arthritis	[35,37]
	Heart	DGI/endocarditis	[42,43,44,45,50]
	Skin (extragenital)	DGI/cutaneous infection	[51,52,53]
	Brain	DGI/meningitis	[38,39,40,54]
	Pharynx	DGI/pharyngitis	[55]
		Oro- and nasopharyngeal infections	[32,56,57,58,59,60,61,62]
		Tonsillitis	[63]
	Mouth/lips	Stomatitis
	Parotid glands	Parotitis	[64]
	Tendon	DGI/tenosynovitis	[61]
	Eye	Keratoconjunctivitis	[31,65]
		Conjunctivitis/ophthalmia neonatorum	[49,62,66,67,68,69,70,71,72]
	Scalp	Scalp abscess	[73]
	Breast	Mastitis/breast abscess	[74,75,76,77]
N. meningitidis 2	Genitourinary tract	Vaginitis	[29,78,79,80,81]
		Urethritis	[30,82,83,84,85,86,87,88,89,90,91,92,93,94]
		Cervicitis	[78,79,83,85,86,89,90,93,95,96,97,98]
		Anal canal infection/proctitis	[83,86,88,89,90]
		Intrauterine infection	[99]
	Eye	Conjunctivitis	[81,97,100,101,102,103,104,105,106,107,108,109,110,111]
		Endophthalmitis	[112,113,114,115,116,117,118,119,120]
		Panophthalmitis	[121]
Commensal Neisseria species 3
N. bacilliformis	Heart	Endocarditis	[122,123]
	Oral cavity/fistula	Submandibular wound	[124]
	Sputum	Possible bronchitis	[124]
	Sputa	Possible bronchitis	[124]
	Lung	Lung abscess	[124]
	Blood	(Insufficient clinical data)	[124]
N. canis	Lung	Bronchiectasis	[125]
	Skin	Purulent wound/cellulitis	[126]
N. cinerea	Blood	Septicemia	[127,128]
	Brain	Meningitis	[128]
	Genitourinary tract	Genital infections	[129]
		Urinary infection	[130]
	Peritoneum	Peritonitis	[131]
	Eye	Conjunctivitis/ophthalmia neonatorum	[132,133]
N. dumasiana	Sputum	(Insufficient clinical data)	[134]
N. elongata	Heart	Endocarditis	[135,136]
	Blood	Septicemia	[137]
	Bone	Osteomyelitis	[138]
N. flava	Heart	Rheumatic heart disease/ventricular septaldefect/endocarditis	[139]
		Endocarditis	[140]
	Blood	Sepsis/conjunctival petechia	[139]
N. flavescens	Heart	Endocarditis	[141,142]
	Brain	Meningitis	[143,144]
	Blood	Septicemia	[145,146]
	Lung	Pneumonia/empyema	[147]
	Genitourinary tract	Genital infections	[148]
N. lactamica	Brain	Meningitis	[149,150]
	Blood	Septicemia	[145,151]
	Pharynx	Pharyngitis	[152]
	Lung	Cavitary lesion	[153]
		Pneumonia	[154]
	Genitourinary tract	Genital infections	[129,155,156]
N. mucosa	Heart	Endocarditis	[157,158,159]
	Brain	Meningitis	[160,161]
	Blood	Septicemia	[145,162]
	Lung	Empyema	[163]
	Genitourinary tract	Genital infections	[129]
		Urinary infection	[164]
	Viscera	Botryomycosis	[165]
	Joints	Arthritis	[166,167]
N. oralis	Bladder	Cystitis	[168]
	Gingiva	Healthy gingival plaque/subgingival oral biofilm	[169]
	Blood	(Insufficient clinical data)	[169]
	Urinary tract	(Insufficient clinical data)	[169]
	Paracentesis fluid	(Insufficient clinical data)	[169]
N. perflava	Heart	Endocarditis	[170,171]
N. shayeganii	Sputum	(Insufficient clinical data)	[172]
	Skin	Arm wound	[172]
N. sicca	Heart	Endocarditis	[173,174,175,176]
	Brain	Meningitis	[177,178]
	Blood	Septicemia	[145]
	Lung	Pneumonia	[179]
	Genitourinary tract	Genital infections	[148,180,181]
		Urinary infection	[182]
N. subflava	Heart	Endocarditis	[183,184]
	Brain	Meningitis	[185,186,187]
	Blood	Septicemia	[145,186]
	Genitourinary tract	Genital infections	[148,180,188]
		Urinary infection	[189]
N. wadsworthii	Skin	Hand wound	[172]
	Peritoneal fluid	(Insufficient clinical data)	[172]
N. weaveri	Blood	Septicemia	[190]
	Sputum	Bronchiectasis	[191]
	Peritoneum	Peritonitis	[192]
	Skin	Wound	[193,194]
N. zoodegmatis	Skin	Ulceration	[195]

Table 1 Legend. Only exemplar clinical case reports of unusual infections with pathogenic and commensal Neisseria species are listed in the Table 1; characteristic (typical) infections with gonococcus (gonorrhea) and meningococcus (meningitis and septicemia) are not included. ¹ Many of the unusual gonococcal infections are associated with preceding disseminated gonococcal infection (DGI) (consequential of initial gonorrhea) or serve as a portal of entry for gonococcal septicemia and/or other manifestations of DGI. ² Some clinical cases of unusual meningococcal infections are either associated with preceding meningococcemia or further develop sepsis (systemic (invasive) meningococcal disease (SMD)) as a consequence of the corresponding primary infection. ³ Commensal Neisseria species are not associated with disease, although they may behave as opportunistic pathogens. In many of these cases, an overlap of clinical features for different conditions is generally observed (e.g., invasion of the bloodstream by Neisseria may also occur in cases of endocarditis and meningitis). The current, accepted nomenclature for the Neisseria species is provided in the Table 1, so the corresponding classifications for generic and specific names allocated in the oldest reports may vary (e.g., ‘Micrococcus pharyngis siccus’ in reference [174] refers to Neisseria sicca, as stated in the Table 1). Gram-negative diplococci Moraxella (Branhamella) catarrhalis (formely known as N. catarrhalis) is a common, essentially harmless inhabitant of the pharynx, but can also behave as an opportunistic pathogen, causing infections mainly in both the upper and lower respiratory tract. Due to its high phenotypic resemblance to the Neisseriae, it was frequently confused with another pharyngeal resident, Neisseria cinerea [196]. With this proviso in mind, old case reports of infection with ‘N. catarrhalis’ are discussed in the text but are not included in this Table 1 due to its re-classification [197].