Disseminated neisserial infection in pregnancy: the empress may have a change of clothing.

A case of disseminated neisserial disease during pregnancy with good perinatal outcome is presented along with two examples of disseminated N. meningitidis from endocervical site. Upon close review, it is clear that the biological similarities of both N. gonorrhoeae and N. meningitidis may outweigh their differences. The two organisms may behave in clinically indistinguishable fashion and probably justify a more cautious approach to the clinical syndromes we have considered the inviolate domain of the gonococcus. The management of disseminated neisserial disease in pregnancy should include prompt empiric parenteral therapy while aggressive diagnostic confirmation of the organism is pursued. In addition, neonatal conjunctivitis caused by a Gram-negative diplococci should be treated parenterally until clinical response and identity of the organism is confirmed.