• Ocul. Immunol. Inflamm. · Oct 2014

    Case Reports

    Neisseria meningitidis endogenous endophthalmitis with meningitis in an immunocompetent child.

    • Imran H Yusuf, Zuzana Sipkova, Sejal Patel, and Larry Benjamin.
    • Stoke Mandeville Hospital, Department of Ophthalmology , Mandeville Road, Aylesbury , UK.
    • Ocul. Immunol. Inflamm. 2014 Oct 1; 22 (5): 398-402.

    AbstractNeisseria meningitidis is a major cause of childhood morbidity and mortality worldwide. We describe an exceptional case of an immunocompetent 15-month-old child presenting with a unilateral anterior uveitis, hypopyon, and sepsis. Anterior chamber aspirate demonstrated gram-negative cocci before Neisseria meningitidis was identified in blood and cerebrospinal fluid. Meningococcal endophthalmitis presents variably with sepsis, meningitis, or isolated ocular symptoms. Diagnosis is a clinical challenge, requiring diagnostic sampling and treatment from both pediatricians and ophthalmologists. Delayed or incorrect treatment risks blindness, disability, or death. Simultaneous invasion of meningococcus across intact blood-brain and blood-ocular barriers in this child suggests antigenic correlates between meningeal and ocular endothelial interfaces. Meningococcus is an exclusively human pathogen; research is hampered by the lack of animal models. This clinical observation suggests the potential of a novel in vitro experimental approach of using ocular tissue from eye banks to further elucidate the meningococcal-endothelial interaction that underpins meningococcal disease.

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