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Ocul Immunol Inflamm. 2014 Oct;22(5):398-402. doi: 10.3109/09273948.2013.854392. Epub 2013 Dec 2.

Neisseria meningitidis endogenous endophthalmitis with meningitis in an immunocompetent child.

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Stoke Mandeville Hospital, Department of Ophthalmology , Mandeville Road, Aylesbury , UK.


Neisseria meningitidis is a major cause of childhood morbidity and mortality worldwide. We describe an exceptional case of an immunocompetent 15-month-old child presenting with a unilateral anterior uveitis, hypopyon, and sepsis. Anterior chamber aspirate demonstrated gram-negative cocci before Neisseria meningitidis was identified in blood and cerebrospinal fluid. Meningococcal endophthalmitis presents variably with sepsis, meningitis, or isolated ocular symptoms. Diagnosis is a clinical challenge, requiring diagnostic sampling and treatment from both pediatricians and ophthalmologists. Delayed or incorrect treatment risks blindness, disability, or death. Simultaneous invasion of meningococcus across intact blood-brain and blood-ocular barriers in this child suggests antigenic correlates between meningeal and ocular endothelial interfaces. Meningococcus is an exclusively human pathogen; research is hampered by the lack of animal models. This clinical observation suggests the potential of a novel in vitro experimental approach of using ocular tissue from eye banks to further elucidate the meningococcal-endothelial interaction that underpins meningococcal disease.


Blood-brain barrier; blood-ocular barrier; endogenous endophthalmitis; endothelium; hypopyon; meningcoccal sepsis; meningitis; meningococcus

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