Adult conjunctivitis secondary to dual infection with Chlamydia trachomatis and Neisseria gonorrhoeae - A case report

Abstract

PurposeAlthough Chlamydia trachomatis and Neisseria gonorrhoeae are the commonest sexually transmitted infections in England, reports of ocular co-infection in the literature are limited. We report such a case which responded well to treatment, and discuss the literature and evidence currently available with regards to management of these cases.ObservationsThe patient is a 48-year-old bisexual gentleman who presented to the eye clinic of a UK hospital with redness, discharge and blurred vision in his left eye for one week. Initially he had mucopurulent discharge but his cornea was clear. He did not comply with prescribed treatment and returned two days later with bilateral symptoms and corneal thinning in his left eye peripherally.PCR tests for Chlamydia trachomatis and Neisseria gonorrhoeae were positive and the patient was commenced on intravenous ceftriaxone, oral and topical levofloxacin eye drops. After 48 hours of inpatient treatment the patient showed clinical improvement.Conclusions and importanceOphthalmologists should be aware of the possibility that Chlamydia trachomatis and Neisseria gonorrhoeae can cause co-infection in adult conjunctivitis, and of the straightforward method of treatment for such individuals. Delayed diagnosis and treatment of affected patients can lead to corneal complications and potential blindness. It is advisable to discuss these cases with the local microbiology service wherever possible, and referral to a sexual health service is imperative.

Screening for Chlamydia and Gonorrhea in Youth Correctional Facilities, Utah, USA

“…In male patients, C. trachomatis and N. gonorrhoeae can result in epididymitis, prostatitis, and infertility ( 5 – 7 ). In both sexes, the sequelae of C. trachomatis and N. gonorrhoeae include reactive arthritis, proctitis, conjunctivitis, and a higher risk for acquiring more serious infections such as HIV ( 7 , 8 ).…”

“…In male patients, C. trachomatis and N. gonorrhoeae can result in epididymitis, prostatitis, and infertility (5-7). In both sexes, the sequelae of C. trachomatis and N. gonorrhoeae include reactive arthritis, proctitis, conjunctivitis, and a higher risk for acquiring more serious infections such as HIV (7,8).A 2022 systematic review showed that adolescents in juvenile detention centers are at a higher risk for STIs than for the general population and that STI screening in correctional settings is cost-saving, is feasible, and should be performed immediately upon intake as an…”