Neisseria meningitidis keratitis in adults: a case series.
BACKGROUND
The aim of this case series is to describe the clinical course of 2 patients with Neisseria meningitidis corneal ulcers.


METHODS
A 49-year-old man (Patient 1) and a 22- year-old man (Patient 2) both experienced eye pain and were found to have corneal ulcers with surrounding infiltrate and ground-glass appearance. Gram-negative diplococci were seen in the first case. N. meningitidis was isolated in culture of corneal scrapings from both patients.


METHODS
Patient 1 was treated with levofloxacin (0.5%) and cefazolin (50 mg/mL) eye drops hourly and intravenous ceftriaxone and oral rifampicin. Patient 2 was treated with cefazolin (50 mg/mL) and gentamicin (14 mg/mL) eye drops hourly, as well as intravenous ceftriaxone.


RESULTS
The corneal ulcers resolved with anterior stromal scarring and no impairment of vision.


CONCLUSIONS
Corneal ulcers caused by N. meningitidis may respond well to treatment without permanent visual sequelae. However, in view of the potential ocular and systemic complications, it is important to investigate and treat patients with N. meningitidis infection aggressively.
Tan
Colin S H
CS
The Eye Institute, National Healthcare Group, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore. Colintan_eye@yahoo.com.sg
Krishnan
Prabha U
PU
Foo
Fong Yee
FY
Pan
James C H
JC
Voon
Li Wern
LW
D000328:Adult; D003315:Cornea / Q000382:microbiology* / Q000473:pathology; D003937:Diagnosis, Differential; D015818:Eye Infections, Bacterial / Q000382:microbiology* / Q000473:pathology; D006801:Humans; D007634:Keratitis / Q000382:microbiology* / Q000473:pathology; D008297:Male; D008589:Meningococcal Infections / Q000382:microbiology* / Q000473:pathology; D008875:Middle Aged; D009345:Neisseria meningitidis / Q000302:isolation & purification*