Acute Conjunctivitis Caused by a Gram-Negative Diplococcus Resembling the Gonococcus.

THE following notes seem to lend interest to at least one of those many relatively nameless members of the Neisseria which are found in the upper respiratory tract. In November, I937, a hospital patient coughed into the right eye of one of us (an apprentice to medicine) a quantity of sputum which required forcible lavage for its removal. No sign appeared until the morning of the fifth day after the accident, when the recipient was aroused from sleep by the rapid development of an acute conjunctivitis in the same eye. There was intense vascular engorgement with local cedema; no ulcer or other cause could be seen; the intense pain necessitated morphia, and there was profuse lachrymation, but no pus formation, although this occurred later. A loopful of tears on a blood-agar plate gave rise within twentyfour hours incubation to a copious and pure growth of a typical Neisserian coccus, of which the similarities to and the differences from the gonococcus will be shown in due course. The hospital patient had now been found to have florid secondary syphilis. In view of the frequency of the co-existence in the same patient of syphilis and gonorrhcea, and also the recording from time to time of the presence of gonococcus in the pharynx of cases of gonorrhcea, the culture was tested serologically. The result, within the claims of the particular technique used (Price's), would have classified the organism as a gonococcus, a finding which, not being quite in accord with preconceived notions, we decided to investigate further. Meanwhile we shall refer to the microbe as " Coccus X." The conjunctivitis subsided in a few days; much more