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International Ophthalmology

, Volume 32, Issue 4, pp 401–403 | Cite as

Bilateral anterior uveitis in a patient with bacterial meningitis

  • Kazuyoshi Otomo
  • Toshikatsu Kaburaki
  • Takashi Shigeeda
  • Mituko Takamoto
  • Hidetoshi Kawashima
  • Makoto Araie
Case Report

Abstract

We report a case of bilateral iridocyclitis accompanied by bacterial meningitis in an immunocompetent patient. Case report. A 48 year-old healthy female visited our hospital with strong headache, fever, bilateral hyperemia, and blurred vision in both eyes. A slit-lamp examination revealed moderate cells and flare in the anterior chamber of both eyes, with fine keratoprecipitates. There were no obvious inflammatory changes in the vitreous, retina, and optic disc of both eyes. Elevation of peripheral blood white blood cells, C-reactive protein, and an elevated number of cerebrospinal fluid (CSF) cells suggested bacterial meningitis. The patient was admitted to our hospital and received intravenous antibiotics. Finally, a CSF culture revealed infection with gram-positive rods, suspected Listeria monocytogenes, confirming bacterial meningitis. For iridocyclitis, we prescribed betamethasone eyedrops and 0.5 % tropicamide eyedrops with intravenous adminstration of systemic antibiotics. 3 days later, her headache and bilateral hyperemia disappeared. This case is better described as sterile reactive uveitis rather than endogenous bacterial endophthalmitis, because bilateral anterior uveitis was resolved without chronic uveitis, iris atrophy, and vitreous opacity. When clinicians see patients with meningitis and bilateral anterior uveitis, sterile reactive uveitis should be considered in the differential diagnosis of uveitis.

Keywords

Anterior uveitis Iridocyclitis Bilateral Bacterial meningitis 

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Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  • Kazuyoshi Otomo
    • 1
  • Toshikatsu Kaburaki
    • 1
  • Takashi Shigeeda
    • 1
  • Mituko Takamoto
    • 1
  • Hidetoshi Kawashima
    • 2
  • Makoto Araie
    • 1
  1. 1.Department of OphthalmologyThe University of Tokyo Graduate School of MedicineBunkyo-kuJapan
  2. 2.Department of OphthalmologyJichi Medical University HospitalShimotsuke-shiJapan

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