Moraga Llop F A, Barquet Esteve N, Domingo Pedrol P, Gallart Catalá A
Hospital Universitario Materno-Infantil Vall d'Hebron, Universitat Autònoma, Barcelona.
Med Clin (Barc). 1996 Jun 22;107(4):130-2.
Neisseria meningitidis is a uncommon cause of acute bacterial conjunctivitis. However, its diagnosis has important therapeutic implications.
From December 1993 to January 1984, a prospective study on acute bacterial conjunctivitis was performed at the Hospital Universitario Materno-Infantil Vall d'Hebron. Primary meningococcal conjunctivitis (PMC) was diagnosed in 34 patients. The diagnosis of PMC was made on the basis of consistent clinical manifestations together with isolation of Neisseria meningitidis from conjunctival exudate culture.
There were 16 men and 18 women with a mean age of 3.5 +/- 3.3 years. PMC was bilateral in 7 patients and unilateral in 27. Initial therapy for PMC included only topical antibiotics in 24 patients and systemic antibiotic therapy in 10. Ten patients (29.4%) developed invasive meningococcal disease. None of the patients died neither developed ocular sequelae. Forty one percent of the patients who received only topical therapy and none [corrected] of those who received systemic therapy, developed invasive meningococcal disease (p = 0.04).
PMC may represent the portal of entry for invasive meningococcal disease, which occurs in almost a third of patients. Patients with PMC and higher risk of developing invasive meningococcal disease are those treated only with topical antibiotic therapy.
脑膜炎奈瑟菌是急性细菌性结膜炎的罕见病因。然而，其诊断具有重要的治疗意义。
1993年12月至1984年1月，在巴塞罗那瓦尔德希伯伦大学母婴医院对急性细菌性结膜炎进行了一项前瞻性研究。34例患者被诊断为原发性脑膜炎球菌性结膜炎（PMC）。PMC的诊断基于一致的临床表现以及从结膜渗出物培养中分离出脑膜炎奈瑟菌。
有16名男性和18名女性，平均年龄为3.5±3.3岁。PMC双侧发病7例，单侧发病27例。PMC的初始治疗中，24例患者仅使用局部抗生素，10例患者接受全身抗生素治疗。10例患者（29.4%）发生侵袭性脑膜炎球菌病。所有患者均未死亡，也未出现眼部后遗症。仅接受局部治疗的患者中有41%发生侵袭性脑膜炎球菌病，而接受全身治疗的患者中无一例发生（p = 0.04）。
PMC可能是侵袭性脑膜炎球菌病的侵入门户，几乎三分之一的患者会发生侵袭性脑膜炎球菌病。仅接受局部抗生素治疗的PMC患者发生侵袭性脑膜炎球菌病的风险更高。
