To the Editor.
—De Luise et al1 recently recalled the ocular signs of meningococcal disease. Ocular complications of bacterial septicemia are rare, but Neisseria meningitidis was once frequently implicated.2 Since the use of antibiotics, other gram-negative bacteria are now more frequently responsible, as reported in the case below.
Report of a Case.
—A 62-year-old man had undergone a cholecystectomy 30 years prior to being seen for an intercostal herpes zoster eruption in July 1982.After four days with febrile diarrhea, the patient was admitted to our hospital on Nov 23,1982, because of an acute meningeal syndrome with stupor and hyperpyrexia (40 °C) without focal neurologic symptoms. The cerebrospinal fluid was purulent and without bacteria, but two blood cultures were positive for Klebsiella pneumoniae. There were abnormal hepatic and renal symptoms: right hypochondrium pain, hematuria, and proteinuria. The erythrocyte sedimentation rate was between 85 to 100 mm/hr and the
Muller J, Destee A, Guilbert F, Verier A, Warot P. 'Spontaneous' Klebsiella pneumoniae Septicemia With Ocular and Meningeal Localizations. Arch Ophthalmol. 1985;103(8):1109. doi:10.1001/archopht.1985.01050080021003