以往对于脑膜炎双球菌作为原发性下呼吸道感染的致病菌的认识是不够的,认为脑膜炎双球菌性肺炎只是继发于脑膜炎双球菌败血症的一种少见的化脓性迁徙性合并症,并认为脑膜炎双球菌鼻咽部以外的播散几乎均是由血源侵犯引起的。但是,近年来逐渐发现有原发性脑膜炎双球菌性肺炎的病例。作者报导3名由脑膜炎双球菌Y组引起的原发性肺炎病例,这些患者均无脑膜炎或败血症的表现,血培养阴性,临床上这些患者均为年青人,一向体健,病情于2～3星期内逐渐加重,患者并无呼吸窘迫或肺外病变的表现,因此其临床过程并无特殊性,而且作普通的咯痰培养或鼻咽部、喉部拭子培养并不产生阳性结果,而只有经气管吸取标本才能获得脑膜炎双球菌Y组的阳性培养,因而在临床上易致漏诊。两名患者曾先有病毒感染,一为流感病毒B,一 In the past, awareness of meningococcus as a pathogen of primary lower respiratory tract infection was not enough, and meningococcal pneumonia was considered to be a rare septic migratory complication secondary to meningococcal septicemia , And that disseminations outside the nasopharynx of meningococcus are almost always caused by blood-borne invasion. However, cases of primary meningococcal pneumonia have been gradually found in recent years. The authors report three cases of primary pneumonia caused by meningococcal Y group, these patients were no meningitis or sepsis performance, blood culture negative, clinically these patients are young, has been healthy, the disease in 2 ~ 3 weeks gradually increased, the patient did not have respiratory distress or extrapulmonary disease performance, so the clinical course is not specific, and for ordinary sputum culture or nasopharyngeal, laryngeal swab culture did not produce positive results , But only by tracheal aspiration specimens to obtain positive meningococcal Y group culture, which is prone to cause missed diagnosis in the clinic. Two patients had a previous viral infection, one for influenza B, one