To report a case of bilateral endogenous endophthalmitis in a Streptococcus pneumoniae meningitis patient.

A 45-year-old woman with bacterial meningitis was referred to the ophthalmologic clinic with acute visual impairment in both eyes. The patient's visual acuities were hand motion in both eyes. Ophthalmoscopy revealed inflammation in the anterior chamber and vitreous opacities in both eyes. Streptococcus pneumoniae was isolated in the cerebrospinal fluid sample, but not in vitreal, blood samples. Vision improved to 70/100 in the right eye and 2/100 in the left eye after 8 days of treatment.

Endogenous endophthalmitis constitutes a rare complication of Streptococcus pneumoniae meningitis, and a prompt diagnosis and administration of empirical intravitreal antibiotics can lead to a more favorable visual prognosis.