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November 1997

Bilateral Endophthalmitis as an Initial Presentation in Meningococcal Meningitis

Author Affiliations

Albuquerque, NM

Arch Ophthalmol. 1997;115(11):1472-1473. doi:10.1001/archopht.1997.01100160642024

Endogenous endophthalmitis can occur in immunocompetent children with distant localized infections, such as meningitis or cellulitis, that are associated with bacteremia. Neisseria meningitidis is one of the more common pathogens causing endophthalmitis in children with meningitis, bacteremia, or both.

Report of a Case.  In January 1996, a 14-year-old, healthy boy had a 4-day history of fever, vomiting, and subjective neck stiffness, and a 3-day history of eye pain and rash. On the fourth day, he had decreasing vision and increasing pain in both eyes. Optometric examination documented visual acuity of 20/400 OU and intraocular pressure in the mid-40-mm Hg range. He was referred to the local emergency department for his fever, vomiting, nuchal rigidity, petechial rash on the trunk, and purpuric lesions on the extremities. The peripheral blood cell count showed a leukocyte count of 12.1×109/L, with 0.97 neutrophils. A lumbar puncture revealed cloudy cerebrospinal fluid (glucose, 0.83

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