Cytokine production was determined in vitro after stimulation with three different Neisseria meningitidis (NM) strains. Virulent NM B strain isolated from a patient with mild course of invasive meningococcal disease (IMD) elicited higher cytokine production than NM B and NM C hypervirulent strains isolated from patients with moderate and fatal course of IMD, respectively. Endotoxin concentration after in vitro stimulation correlated with cytokine production: the highest endotoxin levels were observed with virulent NM B strain. Serum cytokines and endotoxin levels showed an opposite trend. These results suggest that inflammatory response during IMD is predominantly influenced by host factors.