Isolated Neisseria meningitidis-associated endophthalmitis in an immunocompetent host: case report and literature review.

Access microbiology Pub Date : 2025-03-07 eCollection Date: 2025-01-01 DOI:10.1099/acmi.0.000901.v3
Calvin Ka-Fung Lo, Lauren Hughes, Cole Schonhofer, William R Bowie, Iain McCormick, Andrew Kirker
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Abstract

Introduction. Neisseria meningitidis is a Gram-negative diplococcus with significant infectious sequelae, including meningitis and disseminated meningococcal bloodstream infection. Rarely has it been reported in the context of endophthalmitis without central nervous system involvement. We report a clinical case of isolated meningococcal endophthalmitis in an immunocompetent patient and present a literature review on published cases, including treatment regimens and clinical outcomes. Case Presentation. A 51-year-old male with no significant medical history presented to the emergency department with acute vision loss in the right eye after returning from Mexico. Ophthalmic examination was consistent with endophthalmitis, presumed to be endogenous in the absence of recent ocular trauma or surgery. Vitreous culture was positive for growth of Gram-negative diplococci, subsequently identified as N. meningitidis. Blood and cerebrospinal fluid cultures were negative for growth of similar or implicative pathogens. There was no evidence of disseminated meningococcal infection; imaging did not demonstrate any drainable collections or sequelae of extension into the central nervous system. The patient was treated with intravitreal antibiotics as well as topical steroids and antibiotics. In addition, he completed a 2-week course of systemic antibiotics. Visual outcome was unfortunately poor. Conclusion. This case illustrates a rare case of isolated endophthalmitis secondary to meningococcus, presumably from a nasopharyngeal source. In these clinical scenarios, clinicians should perform a thorough evaluation for predisposing immunodeficiencies.

免疫正常宿主中分离的脑膜炎奈瑟菌相关眼内炎:病例报告和文献复习。
介绍。脑膜炎奈瑟菌是一种革兰氏阴性双球菌,具有显著的感染性后遗症,包括脑膜炎和播散性脑膜炎球菌血流感染。很少有报道在眼内炎的背景下,没有中枢神经系统受累。我们报告一例孤立性脑膜炎球菌性眼内炎的临床病例,并对已发表的病例进行文献综述,包括治疗方案和临床结果。例演示。51岁男性,无明显病史,从墨西哥返回后右眼急性视力丧失,就诊于急诊科。眼科检查与眼内炎一致,在没有近期眼部外伤或手术的情况下推测为内源性。玻璃体培养对革兰氏阴性双球菌生长呈阳性,随后鉴定为脑膜炎奈瑟菌。血液和脑脊液培养阴性生长相似或牵连的病原体。没有播散性脑膜炎球菌感染的证据;影像学未见任何可引流的积液或延伸至中枢神经系统的后遗症。患者接受玻璃体内抗生素以及局部类固醇和抗生素治疗。此外,他完成了2周的全身抗生素疗程。不幸的是,视觉效果很差。结论。本病例是一例罕见的孤立性眼内炎继发于脑膜炎球菌,可能来自鼻咽源。在这些临床情况下,临床医生应该对易感免疫缺陷进行彻底的评估。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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