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Prevalence of gonococcal conjunctivitis in adults and neonates

L McAnena1, S J Knowles2, A Curry3

  • 1Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland.

Eye (London, England)
|April 25, 2015
PubMed

Insights

Gonococcal conjunctivitis (GC) is rare in newborns but affects young adults, primarily males. Prompt diagnosis and treatment are crucial for managing this eye infection and preventing complications.

Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Microbiology

Background:

  • Gonococcal conjunctivitis (GC) is a serious ocular infection caused by Neisseria gonorrhoeae.
  • Neonatal GC is a preventable cause of blindness, historically managed with silver nitrate or antibiotic eye drops.
  • Adult GC can lead to severe visual impairment if not promptly treated.

Purpose of the Study:

  • To determine the prevalence of gonococcal conjunctivitis (GC) at two tertiary hospitals between 2011 and 2013.
  • To describe the clinical characteristics, demographics, and antibiotic susceptibility of Neisseria gonorrhoeae ocular infections.

Main Methods:

  • Retrospective collection of demographic, clinical, and microbiological data from laboratory-confirmed GC cases.
  • Analysis of data from a maternity hospital (NMH) and an ophthalmic hospital (RVEEH).

Main Results:

  • No neonatal GC cases were identified at NMH out of 27,556 live births.
  • Fourteen GC cases were diagnosed at RVEEH, with a prevalence of 0.19 per 1000 attendees.
  • All nine tested isolates were sensitive to ceftriaxone and ciprofloxacin; 64.3% of patients were male, mean age 18 years.
  • Common symptoms included unilateral conjunctival injection and purulent discharge; 8 cases had visual impairment at presentation.
  • Corneal involvement occurred in 25% of patients; uveitis was absent. Treatment was altered in two-thirds of patients post-culture/PCR results.

Conclusions:

  • Gonococcal conjunctivitis is rare in neonates but presents in young adults, with a male predominance.
  • High clinical suspicion for GC is warranted in unilateral purulent conjunctivitis.
  • Early laboratory confirmation (PCR/culture) and adherence to antibiotic guidelines are essential for effective management and recovery.
Abstract

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