Blindness in Pneumococcal Meningoencephalitis, A Case Report and Literature Review

Abstract

The incidence of blindness caused by pneumococcal meningoencephalitis is rare, and previously undefined in adults.  Here we present the case of a patient with pneumococcal meningoencephalitis who developed complete bilateral vision loss, and describe her disease course and outcome.  A literature review was done and only two other cases were found in adults.   We excluded cases where blindness was caused by an occipital lobe or pituitary lesion, or an ocular abnormality.   Possible mechanisms include increased intracranial pressure causing ischemia, vasculitis, or optic neuritis.  There was a wide range of outcomes, from partial vision improvement, to dependence on Braille, to death.  Our findings indicate that vision loss after pneumococcal meningoencephalitis is extremely rare, therefore providing prognosis to patients and families remains difficult.