Introduction: Meningococcal disease remains a major cause of morbidity and mortality in children globally. The most common serogroups in Europe are B and C. There has been a downward trend in the incidence of the latter because of the immunization schedules in most European countries. N. meningitidis W135, otherwise referred to as MenW is an uncommon serogroup but gained popularity following the Hajj outbreaks in the year 2000.
Case Report: A previously well 11-month-old girl presented with varicella rash, high grade pyrexia. She became very irritable with bulging anterior fontanelle. Examination findings revealed nuchal rigidity. MenW and varicella zoster virus were isolated in cerebrospinal fluid (CSF). She received a three-week course of intravenous ceftriaxone and acyclovir. Magnetic resonance imaging scan of the brain showed some empyema collection in the right frontal lobe. She had some motor regression. She recovered but with residual sensorineural hearing loss.
Conclusion: This case might represent an emerging trend of this rather uncommon serogroup. This has been anticipated by some European countries where MenACWY vaccine has been incorporated in their immunization schedules.

Keywords: MenACWY vaccine, Meningococcal meningitis, MenW serogroup, Varicella-zoster virus