Meningococcal conjunctivitis in neonates.

Three neonates were admitted with purulent conjunctivitis, and an initial diagnosis of gonococcal ophthalmia was made because gram-negative diplococci were seen on gram stains of conjunctival exudates. Meningococci were grown from eye exudates of all three infants and from the blood of one. Since Neisseria species other than gonococci can sometimes cause neonatal ophthalmia, an etiologic diagnosis should not be made until microbiologic identification is complete. Before the results of definitive bacteriologic studies are known, care should be taken in discussing the cause of the infection with family members and in planning their medical management. Since systemic infections may occur in some infants with ophthalmia due to Neisseria species, blood and spinal fluid in addition to eye exudate cultures may be indicated, and patients should be managed with parenteral antibiotics.