Neisseria meningitidis represents an uncommon pathogen of acute bacterial conjunctivitis. In this brief report, we describe a case of meningococcal conjunctivitis in an immunocompetent adult male, with a review of the literature. The patient went to the outpatient ophthalmology clinic complaining of severe ocular discomfort, burning, and redness for more than 2 weeks and, at slit lamp examination, he was diagnosed with a mild conjunctivitis. Microbiology cultures of ocular swabs revealed the growth of colonies, as pure culture, identified as N. meningitidis of serogroup B. A diagnosis of primary meningococcal conjunctivitis was made and treatment of patient with intramuscular injections of ceftriaxone in addition to topical moxifloxacin eye drops for 2 weeks led to clinical improvement and, finally, to a complete recovery, in accordance with microbiological findings. Ophthalmologists must be aware of the possibility of primary meningococcal conjunctivitis cases, even uncommon, and the need to treat with systemic antibiotics and their close contacts with adequate antibiotic chemoprophylaxis.

1.
Harrison
OB
,
Claus
H
,
Jiang
Y
,
Bennett
JS
,
Bratcher
HB
,
Jolley
KA
.
Description and nomenclature of Neisseria meningitidis capsule locus
.
Emerg Infect Dis
.
2013
;
19
(
4
):
566
73
.
2.
Claus
H
,
Maiden
MCJ
,
Wilson
DJ
,
McCarthy
ND
,
Jolley
KA
,
Urwin
R
.
Genetic analysis of meningococci carried by children and young adults
.
J Infect Dis
.
2005
;
191
(
8
):
1263
71
.
3.
Brouwer
MC
,
de Gans
J
,
Heckenberg
SGB
,
Zwinderman
AH
,
van der Poll
T
,
van de Beek
D
.
Host genetic susceptibility to pneumococcal and meningococcal disease: a systematic review and meta-analysis
.
Lancet Infect Dis
.
2009
;
9
(
1
):
31
44
.
4.
Cartwright
KAV
,
Ala’Aldeen
DA
.
Clinical aspects
.
J Infect
.
1997
;
34
(
1
):
15
9
.
5.
Elias
J
,
Frosch
M
,
Vogel
U
.
Neisseria
12th ed
Manual for clinical microbiology
Washington, DC, USA
ASM Press
2019
. p.
640
.
6.
Leung
AKC
,
Hon
KL
,
Wong
AHC
,
Wong
AS
.
Bacterial conjunctivitis in childhood: etiology, clinical manifestations, diagnosis, and management
.
Recent Pat Inflamm Allergy Drug Discov
.
2018
;
12
(
2
):
120
7
.
7.
Azari
AA
,
Barney
NP
.
Conjunctivitis: a systematic review of diagnosis and treatment
.
JAMA
.
2013
;
310
(
16
):
1721
9
.
8.
Teweldemedhin
M
,
Gebreyesus
H
,
Atsbaha
AH
,
Asgedom
SW
,
Saravanan
M
.
Bacterial profile of ocular infections: a systematic review
.
BMC Ophthalmol
.
2017
;
17
(
1
):
212
.
9.
Poulos
RG
,
Smedley
EJ
,
Ferson
MJ
,
Bolisetty
S
,
Tapsall
JW
.
Refining the public health response to primary meningococcal conjunctivitis
.
Commun Dis Intell Q Rep
.
2002
;
26
(
4
):
592
5
.
10.
Chacon-Cruz
E
,
Alvelais-Palacios
JA
,
Rodriguez-Valencia
JA
,
Lopatyn- sky-Reyes
EZ
,
Volker-Soberanes
ML
,
Rivas-Landeros
RM
.
Meningococcal neonatal purulent conjunctivitis/sepsis and asymptomatic carriage of N. meningitidis in mother’s vagina and both parents’ nasopharynx
.
Case Rep Infect Dis
.
2017
;
2017
:
6132857
.
11.
Barquet
N
,
Gasser
I
,
Domingo
P
,
Moraga
FA
,
Macaya
A
,
Elcuaz
R
.
Primary meningococcal conjunctivitis: report of 21 patients and review
.
Rev Infect Dis
.
1990
;
12
(
5
):
838
47
.
12.
Odegaard
A
.
Primary meningococcal conjunctivitis followed by meningitis and septicemia
.
NIPH Ann
.
1983
;
6
(
1
):
55
7
.
13.
Ellis
M
,
Weindling
AM
,
Davidson
DC
,
Ho
N
,
Damjanovic
V
.
Neonatal meningococcal conjunctivitis associated with meningococcal meningitis
.
Arch Dis Child
.
1992
67
10 Spec No
1219
20
.
14.
Irani
F
,
Ruddell
T
.
Meningococcal conjunctivitis
.
Aust N Z J Ophthalmol
.
1997
;
25
(
2
):
167
8
.
15.
Parikh
SR
,
Campbell
H
,
Mandal
S
,
Ramsay
ME
,
Ladhani
SN
.
Primary meningococcal conjunctivitis: summary of evidence for the clinical and public health management of cases and close contacts
.
J Infect
.
2019
;
79
(
6
):
490
4
.
16.
Kenny
JF
.
Meningococcal conjunctivitis in neonates
.
Clin Pediatr
.
1987
;
26
(
9
):
473
6
.
17.
Newton
DA
,
Wilson
WG
.
Primary meningococcal conjunctivitis
.
Pediatrics
.
1977
;
60
(
1
):
104
6
.
18.
Suarez
S
,
Ferroni
A
,
Lotz
A
,
Jolley
KA
,
Guérin
P
,
Leto
J
.
Ribosomal proteins as biomarkers for bacterial identification by mass spectrometry in the clinical microbiology laboratory
.
J Microbiol Methods
.
2013
;
94
(
3
):
390
6
.
19.
Pickering
LK
,
Baker
CJ
,
Kimberlin
DW
,
Long
SS
Report of the committee on infectious diseases
28th ed
Grove Village, IL
American Academy of Pediatrics
2012
.
20.
Deghmane
AE
,
Hong
E
,
Taha
MK
.
Emergence of meningococci with reduced susceptibility to third-generation cephalosporins
.
J Antimicrob Chemother
.
2017
;
72
(
1
):
95
8
.
21.
Vacca
P
,
Fazio
C
,
Neri
A
,
Ambrosio
L
,
Palmieri
A
,
Stefanelli
P
.
Neisseria meningitidis antimicrobial resistance in Italy, 2006 to 2016
.
Antimicrob Agents Chemother
.
2018
62
9
e00207-18
.
22.
England
PH
.
Guidance for the public health management of meningococcal dis- ease in the UK
. In:
Immunisations
, editor.
London, UK
Public Health England
2018
.
23.
Australia CDN
Invasive meningococcal disease CDNA national guidlines for public health units
12 edition
Australia
Department of Health
2017
.
24.
Prevention CfDCa
Chapter 14: meningococcal disease. Pink book: epidemiology and prevention of vaccine-preventable diseases
13th ed
USA
Centers for Disease Control and Prevention
2019
.
25.
NICE
Bacterial meningitis and meningococcal septicaemia: management of bacterial meningitis and meningococcal septicaemia in children and young people younger than 16 years in primary and secondary care
RCOG Press
2010
.
26.
Committee JF
Eye, infections london
BMJ Group and Pharmaceutical Press
2019
. Available from: https://bnf.nice.org.uk/treatment- summary/eye-infections.html.
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