title: [Parainfectious optic neuritis with macular infiltrate in Neisseria meningitidis B meningitis].
abstract: OBJECTIVE
  We report on the case of a young immunocompetent female patient with parainfectious optic neuritis and macular inflitrate due to Neisseria meningitidis B meningitis.
  
  
  METHODS
  Case report RESULTS: A 22-year-old female patient was admitted to the emergency department for intensive care treatment with a strong suspicion of meningitis. Clinical and serological parameters were indicative of a bacterial genesis of the meningitis. By analysis of the cerebrospinal fluid (CSF) Neisseria meningitidis type B could be detected. Subjective and objective symptoms could be improved by immediate intravenous administration of antibiotics; however, 1 day before discharge the patient complained of a sudden left-sided, painful loss of vision with extreme photophobia. The ophthalmoscopic examination revealed profound ciliary injection with slight anterior uveitis and papilledema with macular infiltration and diffuse petechiae-like retinal hemorrhage. After exclusion of viral proliferation in the CSF systemic steroid therapy was carried out together with continuation of antibiotic therapy and the eye was treated with local steroids and mydriatics. This resulted in healing of the ocular inflammation and partial recovery of vision.
  
  
  CONCLUSIONS
  The painful loss of vision in this patient is probably due to parainfectious optic neuritis with macular infiltrate from Neisseria meningitidis B meningitis, which is an unusual course. Despite the rarity of this disease the complication of a parainfectious inflammation of the optic nerve should be considered and appropriate steps taken when the corresponding symptoms occur.
authors.affiliation: Universitätsaugenklinik Genf, Rue Alcide-Jentzer 22, 1205, Genf, Schweiz. aris_c@web.de.
authors.forename: A
authors.initials: A
authors.lastname: Chronopoulos
authors.affiliation: Universitätsaugenklinik Genf, Rue Alcide-Jentzer 22, 1205, Genf, Schweiz.
authors.forename: F
authors.initials: F
authors.lastname: Hoogewoud
authors.affiliation: Universitätsaugenklinik Genf, Rue Alcide-Jentzer 22, 1205, Genf, Schweiz.
authors.forename: H
authors.initials: H
authors.lastname: Steffen
authors.affiliation: Universitätsaugenklinik Genf, Rue Alcide-Jentzer 22, 1205, Genf, Schweiz.
authors.forename: G
authors.initials: G
authors.lastname: Thumann
mesh_terms: D000212:Acyclovir / Q000627:therapeutic use; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D002443:Ceftriaxone / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008266:Macula Lutea; D008585:Meningitis, Meningococcal / Q000175:diagnosis* / Q000188:drug therapy; D009184:Mydriatics / Q000627:therapeutic use; D038541:Neisseria meningitidis, Serogroup B; D009883:Ophthalmic Solutions; D009887:Ophthalmoscopy; D009902:Optic Neuritis / Q000175:diagnosis* / Q000188:drug therapy; D010211:Papilledema / Q000175:diagnosis / Q000188:drug therapy; D012164:Retinal Diseases / Q000175:diagnosis* / Q000188:drug therapy; D014606:Uveitis, Anterior / Q000175:diagnosis / Q000188:drug therapy; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D009184:Mydriatics; D009883:Ophthalmic Solutions; D002443:Ceftriaxone; D000212:Acyclovir
keywords: Macular infiltration; Meningitis; Neisseria meningitidis type B; Parainfectious optic neuritis