Corneal perforation and iris prolapse due to Mima polymorpha

Area of Science:

• Ophthalmology
• Microbiology
• Infectious Diseases

Background:

• Hyperacute conjunctivitis can rapidly progress to severe ocular complications.
• Gram-negative intracellular diplococci on smear are often indicative of Neisseria infections.
• Mimeae bacteria can present with similar clinical and microscopic features to Neisseria.

Purpose of the Study:

• To report the first documented case of corneal perforation caused by Mima polymorpha.
• To highlight the diagnostic challenges in differentiating Mimeae from Neisseria infections.
• To emphasize the importance of accurate bacteriological identification in managing severe conjunctivitis.

Main Methods:

• Clinical case presentation of an 11-year-old girl with hyperacute conjunctivitis.
• Microscopic examination of conjunctival smear showing Gram-negative intracellular diplococci.
• Bacteriological culture and identification of the causative organism.

Main Results:

• The patient presented with corneal perforation and iris prolapse nine days after initial hyperacute conjunctivitis.
• Smear analysis revealed Gram-negative intracellular diplococci.
• Subsequent cultures identified Mima polymorpha as the causative agent.

Conclusions:

• Mima polymorpha can cause severe corneal perforation, clinically and microscopically indistinguishable from Neisseria infections.
• A high index of suspicion and appropriate bacterial cultures are essential to prevent misdiagnosis.
• This case underscores the need for thorough microbiological investigation in severe ocular infections.