Isolated oculomotor nerve palsy in Neisseria meningitidis meningitis: a case report and literature review

Bacterial meningitis remains a significant cause of morbidity and mortality worldwide, despite advances in prevention and treatment. Prompt diagnosis and appropriate management are crucial for optimal patient outcomes. This case report describes a 22-year-old Bangladeshi male who presented to the emergency department with headache, neck pain, vomiting, and left eye ptosis, ultimately diagnosed with Neisseria meningitidis meningitis. This case highlights the rare but significant complication of oculomotor nerve palsy associated with this infection. We also present a literature review discussing the incidence, pathophysiology, and clinical implications of cranial nerve involvement in bacterial meningitis, focusing on N. meningitidis, and explore the diagnostic challenges posed by overlapping clinical presentations of bacterial and tuberculous meningitis, particularly in resource-limited settings.