<i>Neisseria meningitidis</i>: an uncommon cause of conjunctivitis

Lessons from practice Neisseria meningitidis : an uncommon cause of conjunctivitisClinical record A 28-year-old man developed a painful left eye with purulent discharge two weeks after recovering from coronavirus disease 2019.His medical history included multiple sclerosis (untreated) and myopia (managed with contact lenses).Reduced vision prompted emergency department review and slit lamp examination demonstrated diffuse conjunctival erythema without keratitis.Visual acuity was reassuringly intact in the left eye (6/9-1 with glasses, 6/6-2 pinhole) and right eye (6/6-2 with glasses, 6/6-1 pinhole).He was discharged with a diagnosis of bacterial conjunctivitis and prescribed topical chloramphenicol for seven days.Unexpectedly, cultures from an eye swab returned predominant growth of Neisseria meningitidis.The patient was recalled and, following Australian Therapeutic Guidelines, was treated as for invasive meningococcal disease. 1 Intravenous ciprofloxacin 400 mg three times a day was prescribed considering history of ceftriaxone anaphylaxis.High risk contacts were provided rifampicin prophylaxis.The patient was systemically well with no clinical signs of meningism.Blood cultures collected before administration of systemic antibiotics were negative.After receiving five days of ciprofloxacin, the patient was discharged.It was unclear whether he had been previously vaccinated for meningococcal disease.