Tonsillitis due to neisseria meningitidis. Its treatment with rifampin.

The Neisseria species with which most otolaryngologists are familiar is N gonorrhoeae, which can cause acute pharyngitis or tonsillitis. Less well known is N meningitidis, responsible for potentially fatal meningococcal meningitis and meningococcemia. Although present in the carrier state in the pharynx of asymptomatic individuals, N meningitidis previously has not been associated with symptomatic pharyngeal or tonsillar disease. Its isolation from a patient with acute tonsillitis and failure to eliminate the symptoms and organism with penicillin led to use of rifampin. Disappearance of sore throat following use of this antibiotic and inability at completion of therapy to isolate the organism from a homogenate of excised tonsil would appear to implicate the organism as a cause of acute pharyngeal and tonsillar infection. It should be added to the list of organisms capable of producing acute tonsillitis, and rifampin should be considered a chemotherapeutic agent.