A Case of Neisseria sicca Bacteremia Due to Eculizumab Therapy

Eculizumab is a monoclonal antibody indicated for the treatment of complement-mediated disorders. Despite its utility, eculizumab increases risk for infection with Neisseria species, owing to membrane attack complex inhibition. Although this naturally evokes thought of infection with N meningitidis, other Neisseria species also benefit from membrane attack complex disruption. N sicca is a commensal organism that is typically considered nonpathogenic. Here, we describe a case of N sicca bacteremia in a patient receiving eculizumab for atypical hemolytic uremic syndrome and seek to elucidate limitations to current prophylactic recommendations for patients receiving anticomplement therapy.