An unusual presentation of meningococcal meningitis

Purpose To present a unique case of meningococcal meningitis initially manifesting as isolated ocular symptoms in a 19-year-old contact lens wearer. Observations The patient presented with a two-day history of unilateral red and painful eye without systemic symptoms, leading to a preliminary diagnosis of contact lens-associated keratitis. A bacterial swab from the inferior fornix returned positive for N. meningitidis , prompting further evaluation. Diagnostic workup by the internal medicine service supported the diagnosis of meningitis and the patient was treated according to local guidelines. Conclusions and Importance: This case underscores the importance of maintaining a relatively low threshold for obtaining samples for microbiological testing in ocular surface conditions.