Nersseria gonorrhoeae Keratoconjunctivitis

Ullman, Saul; Roussel, Thomas J.; Culbertson, William W.; Forster, Richard K.; Alfonso, Eduardo C.; Mendelsohn, Alan D.; Heidemann, David G.; Holland, Simon

doi:10.1016/s0161-6420(87)33415-3

Cited by 46 publications

(18 citation statements)

References 16 publications

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“…GC may be complicated by uveitis or severe keratitis, sometimes leading to corneal perforation necessitating corneal graft repair, so prompt diagnosis and treatment are essential. [6][7][8][9] There has been an increase in antibiotic resistance amongst gonococcal strains in recent years, including resistance to penicillin, fluoroquinolones, and more recently, oral cephalosporins. [10][11][12] Increasing antimicrobial resistance internationally has sparked concerns that some Neisseria gonorrhoeae strains may become pan-resistant in the near future.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of gonococcal conjunctivitis in adults and neonates

McAnena

Knowles

Curry

et al. 2015

Eye

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Purpose To report the prevalence of gonococcal conjunctivitis (GC) presenting to a tertiary referral maternity hospital (NMH) and a tertiary referral ophthalmic hospital (RVEEH) from 2011 to 2013 and describe the demographics, clinical presentation, and antibiotic susceptibility of Neisseria gonorrhoeae ocular infections. Methods Demographic, clinical, and microbiological data were collected from patients with laboratory confirmed GC. Results There were 27 556 live births at NMH during the study period, and no case of neonatal GC was identified. Fourteen cases of GC were identified at RVEEH in this period, representing a prevalence of 0.19 cases per 1000 eye emergency attendees. Antibiotic susceptibility data were available on nine cases, of which, all were ceftriaxoneand ciprofloxacin sensitive. 64.3% of patients were male, with a mean age of 18 years. The mean duration of symptoms was 3 days. All patients presented with unilateral conjunctival injection and purulent discharge. Eight cases had visual impairment at presentation and their mean visual acuity was 6/15. Corneal involvement was present in 25% of patients. Uveitis was not detected. On receipt of positive culture and/or PCR results, treatment was altered in two thirds of patients. All patients were referred for full STI screening and all patients showed a full clinical recovery 1 week posttreatment. Conclusion We observed that GC presented in young adults with a male predominance and was rare in neonates. In cases of unilateral purulent conjunctivitis, there should be a high clinical suspicion of GC, early swab for PCR and culture, and knowledge of current CDC-recommended antibiotic guidelines.

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Section: Introductionmentioning

confidence: 99%

Prevalence of gonococcal conjunctivitis in adults and neonates

McAnena

Knowles

Curry

et al. 2015

Eye

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“…15 Gonococcal keratoconjunctivitis is a potentially devastating infection because of the ability of N. gonorrhoeae to cause severe, ulcerative keratitis, which may rapidly progress to corneal perforation. [6][7][8] Therefore, it is necessary to obtain an accurate diagnosis and commence parenteral antibiotic treatment as early as possible. However, accurate clinical diagnosis may be delayed due to the relative low incidence of this disease.…”

Section: Discussionmentioning

confidence: 99%

“…A proper diagnosis is vital if this is to be avoided, as the clinical outcome of gonococcal keratoconjunctivitis depends on its level of severity at the commencement of the appropriate therapy. [6][7][8] Ocular gonococcal infection is relatively rare, and during its early stage of development, the resulting keratoconjunctivitis may be attributed to other pathogens, thus delaying a proper clinical diagnosis. Furthermore, N. gonorrhoeae has recently shown increased resistance to antimicrobial agents.…”

Section: Introductionmentioning

confidence: 99%

Surgical management of corneal perforation secondary to gonococcal keratoconjunctivitis

Kawashima

Kawakita

Den

et al. 2007

Eye

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Aims To report five cases of gonococcal keratoconjunctivitis with severe corneal involvement treated with therapeutic keratoplasty. Design Retrospective case series. Methods Five consecutive cases of gonococcal keratoconjunctivitis treated with keratoplasty for corneal perforation, with a mean age of 21.2 years, were analysed by patient's history, surgical approaches, and clinical outcomes, corrected visual acuity at initial visit and last follow-up.

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“…Ocular infection is transmitted through autoinoculation of the bacteria from infected urine and genital secretion by hands in sexually active adults 4–5 . N. gonorrhoeae is one of the few organisms that can penetrate intact corneal epithelium, leading to stromal and epithelial keratitis, rapidly progressing to ulcerative keratitis, and delayed treatment may progress to corneal perforation 2 3 5 6. Gonococcal ocular infection is usually treated with antibiotics, either topical or parenteral, according to the culture result 3.…”

Section: Introductionmentioning

confidence: 99%

Rare case of bilateral perforated corneal ulcer due to gonococcal infection, managed with temporary periosteal graft

2016

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A 17-year-old female patient was referred to Kirana Ophthalmology Unit, Cipto Mangunkusumo Hospital, with a 10-day history of redness and swelling of the eyes, and inability to open them. Other symptoms included pain, blurred vision and excessive yellowish-white discharge from both eyes. There was a history of multiple sexual partners. The patient was assessed with bilateral perforated corneal ulcer due to gonococcal infection, based on the findings of intracellular and extracellular Gram-negative diplococci found on the Gram staining examination. The cornea in both eyes showed perforation with iris prolapse inferiorly. The perforations were treated with temporary periosteal grafts. The grafts remained in place after the surgery. Final uncorrected visual acuity was 6/20 in the right eye and 6/24 in the left eye, a few months after surgery.

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Nersseria gonorrhoeae Keratoconjunctivitis

Cited by 46 publications

References 16 publications

Prevalence of gonococcal conjunctivitis in adults and neonates

Prevalence of gonococcal conjunctivitis in adults and neonates

Surgical management of corneal perforation secondary to gonococcal keratoconjunctivitis

Rare case of bilateral perforated corneal ulcer due to gonococcal infection, managed with temporary periosteal graft

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