BACKGROUND Neisseria meningitidis is a rare cause of acute bacterial conjunctivitis but can progress to invasive meningococcal disease (IMD) in the case and their close contacts. There is, however, a lack of consensus on the clinical and public health management of primary meningococcal conjunctivitis (PMC). METHODS We searched Ovid MEDLINE via PubMed, EMBASE and NHS evidence (up to June 2019) for all publications relating to meningococcal conjunctivitis to provide an evidence-base for developing guidelines for the management of PMC cases and their close contacts. RESULTS The review identified a 10-29% risk of IMD among PMC cases within two days of onset of eye infection (range: 3 h to 4 days). In one study, the risk of IMD in PMC cases treated with systemic antibiotics was 19 times lower than topical antibiotics alone (p = 0.001). IMD among close contacts of PMC cases is uncommon but potentially fatal. Whether meningococcal vaccination for PMC cases or close contacts provides any additional benefit is unclear. CONCLUSIONS Systemic antibiotic treatment significantly reduces the risk of invasive disease in PMC cases, while antibiotic chemoprophylaxis for close contacts will reduce their risk of secondary IMD. These findings need to be highlighted in relevant clinical and public health guidelines.

中文翻译：

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原发性脑膜炎球菌性结膜炎：对病例和近距离接触者进行临床和公共卫生管理的证据摘要。

背景技术脑膜炎奈瑟氏球菌是急性细菌性结膜炎的罕见病因，但在该病例及其密切接触的情况下，可能会发展为侵袭性脑膜炎球菌病（IMD）。但是，在原发性脑膜炎球菌性结膜炎（PMC）的临床和公共卫生管理方面缺乏共识。方法我们通过PubMed，EMBASE和NHS证据（截至2019年6月）在Ovid MEDLINE中搜索了所有与脑膜炎球菌性结膜炎有关的出版物，从而为制定PMC病例及其密切接触者的治疗指南提供了依据。结果该评价确定了在眼感染发作后两天内（范围：3小时至4天），PMC病例中IMD的风险为10-29％。在一项研究中，使用全身性抗生素治疗的PMC病例中IMD的风险比单独使用局部抗生素低19倍（p = 0.001）。PMC病例密切接触者中的IMD并不常见，但可能致命。尚不清楚PMC病例的脑膜炎球菌疫苗接种或密切接触是否能带来任何其他好处。结论全身性抗生素治疗可显着降低PMC病例中浸润性疾病的风险，而对紧密接触者进行抗生素化学预防可降低其继发IMD的风险。这些发现需要在相关的临床和公共卫生指南中加以强调。