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Matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF MS) is used as a rapid and accurate microbial diagnostic method for species identification of pathogens. At our hospital, we use MALDI-TOF MS for rapid identification of microorganisms from pathogen-positive blood cultures. In this article, we report a case where Neisseria meningitidis was confirmed via blood culture using MALDI-TOF MS, but the microbe was ultimately confirmed to be Neisseria cinerea. The 30-year-old patient received a diagnosis of Burkitt lymphoma, and chemotherapy (R-HyperCVAD/ MA; rituximab, cyclophosphamide, vincristine, doxorubicin, dexamethasone, methotrexate, and cytarabine) was started on day 4 of hospitalization (Day 4). On Day 15, his body temperature rose to 39.2°C without symptoms of a common cold. Two sets of blood cultures were initiated on Day 15, and a Gram-negative coccus was detected in an aerobic bottle on Day 16. The acquisition and analysis of mass spectra were performed on a Microflex LT mass spectrometer (Bruker Daltonics, Bremen, Germany) and using the MALDI Biotyper software package (ver. 3.1) with the reference database ver. 3.1.2.0 (3,995 database entries) (Bruker Daltonics). The cultivated bacterium was identified as N. meningitidis with Score Value 2.024 (best match) and Score Value 1.966 (second best match). The Score Value 2.024 of this pathogen was lower than that of a known strain, N. meningitidis (Score Value 2.437). Their MALDI-TOF MS spectra showed different wave patterns and peaks between the pathogen isolated from the patient (Fig. 1) and stocked N. meningitidis (Fig. 2). Colony morphology and microscopic morphology were also different between these microbes. The blood culture sediment of the patient showed nonspecific agglutination in a latex agglutination assay (Pastorex Meningitis; Bio-Rad, Hercules, CA, USA). The strain from

japanese journal of infectious diseases

Misidentification of &lt;i&gt;Neisseria cinerea&lt;/i&gt; as &lt;i&gt;Neisseria meningitidis&lt;/i&gt; by Matrix-Assisted Laser Desorption/Ionization Time of Flight Mass Spectrometry (MALDI-TOF MS)