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.