Introduction: The aim of this case series is to describe the clinical course of 2 patients with Neisseria meningitidis corneal ulcers.Clinical Picture: 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. Treatment: 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. Outcome: 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.
Neisseria meningitidis has been reported as a causative organism for conjunctivitis and endogenous endophthalmitis, more commonly in neonates and young children. A search of the literature on Medline revealed very few reports on infective keratitis caused by N. meningitidis.
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