Meningococcal septicemia presenting as bilateral endophthalmitis

Chacko, Elizabeth; Filtcroft, Ian; Condon, P. I.

doi:10.1016/j.jcrs.2004.06.044

Cited by 9 publications

(5 citation statements)

References 10 publications

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“…Vitreous fluid has been described as a useful specimen for postmortem analysis because the eye is isolated and the fluid is less subjected to contamination or purification ( 7 ). N. meningitidis has been isolated from vitreous humor of living patients, usually in conjunction with symptoms of meningococcal endopthalmitis ( 8 , 9 ). We have demonstrated that postmortem diagnosis of N. meningitidis from vitreous humor and IHC staining < 3 days after death is possible.…”

Section: Discussionmentioning

confidence: 99%

Postmortem Diagnosis of Invasive Meningococcal Disease

Ridpath¹,

Halse²,

Musser³

et al. 2014

Emerg. Infect. Dis.

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Section: Discussionmentioning

confidence: 99%

Postmortem Diagnosis of Invasive Meningococcal Disease

Ridpath¹,

Halse²,

Musser³

et al. 2014

Emerg. Infect. Dis.

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“…Ocular manifestations are similarly inconsistent and may be unilateral 1,4,6-8 or bilateral, 2,3,5 with anterior 6,7 or posterior segment signs, 5,8 or panophthalmitis. 1,2,4,8 Endogenous meningococcal endophthalmitis and may occur in infants, 3 teenagers, 5,6,8 or adults 1,2,4patients are almost universally immunocompetent. [1][2][3][4][5][6][7][8] The variable clinical presentation of meningococcal endophthalmitis presents a diagnostic challenge to both pediatricians and ophthalmologists.…”

Section: Discussionmentioning

confidence: 99%

Neisseria meningitidisEndogenous Endophthalmitis with Meningitis in an Immunocompetent Child

Yusuf

Sipkova

Patel

et al. 2013

Ocular Immunology and Inflammation

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Neisseria 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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“…Simple conjunctivitis can progress into endophthalmitis, which is accompanied usually by severe pain, loss of vision, and redness of the conjunctiva and the underlying episclera. Meningococcal endophthalmitis presents variably with sepsis [102,112,113,121], meningitis [114,115], or isolated ocular symptoms without systemic illness [112,[116][117][118][119], although subsequent development of other expressions of meningococcal disease should not be ruled out [103][104][105]. Thus, delayed or incorrect treatment of meningococcal ocular infections ultimately risks blindness, disability, or death [120] (Table 1).…”

Section: Meningococcal Ophthalmiamentioning

confidence: 99%

Atypical, Yet Not Infrequent, Infections with Neisseria Species

Humbert

Christodoulides

2019

Pathogens

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Neisseria species are extremely well-adapted to their mammalian hosts and they display unique phenotypes that account for their ability to thrive within niche-specific conditions. The closely related species N. gonorrhoeae and N. meningitidis are the only two species of the genus recognized as strict human pathogens, causing the sexually transmitted disease gonorrhea and meningitis and sepsis, respectively. Gonococci colonize the mucosal epithelium of the male urethra and female endo/ectocervix, whereas meningococci colonize the mucosal epithelium of the human nasopharynx. The pathophysiological host responses to gonococcal and meningococcal infection are distinct. However, medical evidence dating back to the early 1900s demonstrates that these two species can cross-colonize anatomical niches, with patients often presenting with clinically-indistinguishable infections. The remaining Neisseria species are not commonly associated with disease and are considered as commensals within the normal microbiota of the human and animal nasopharynx. Nonetheless, clinical case reports suggest that they can behave as opportunistic pathogens. In this review, we describe the diversity of the genus Neisseria in the clinical context and raise the attention of microbiologists and clinicians for more cautious approaches in the diagnosis and treatment of the many pathologies these species may cause.

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Meningococcal septicemia presenting as bilateral endophthalmitis

Abstract: We present a patient with bilateral endophthalmitis as the presenting sign of meningococcal septicemia. Systematic examination and vitreous tap conclusively identified the microbe, and appropriate treatment was administered, with good recovery of vision.

Cited by 9 publications

References 10 publications

Postmortem Diagnosis of Invasive Meningococcal Disease

Postmortem Diagnosis of Invasive Meningococcal Disease

Neisseria meningitidisEndogenous Endophthalmitis with Meningitis in an Immunocompetent Child

Atypical, Yet Not Infrequent, Infections with Neisseria Species

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