Invasive Meningococcal Conjunctivitis

Abstract

To the Editor.— Systemic meningococcal infections are presumed to follow spread of meningococci from the nasopharynx into the blood and then to the cerebrospinal fluid.1However, there have been reports of at least 10 cases of systemic meningococcal infection in which the conjunctiva was the probable portal of entry.2-11The overall incidence of invasive meningococcal conjunctivitis has been estimated to be about 10% of the cases of primary meningococcal conjunctivitis.12 Neisseria meningitidiswas isolated from conjunctival exudate in 21 patients with acute bacterial conjunctivitis who were treated at our hospital during the last 5 years. During this period, 1030 patients with a microbiologically proved acute bacterial conjunctivitis were diagnosed, which gives an incidence forN meningitidisconjunctivitis of 2.0%. Six (28.6%) of our 21 patients with primary meningococcal conjunctivitis, after a mean interval of 27.1 (±23.8) hours from the appearance of the initial ocular symptoms, developed systemic