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Gonorrheal keratoconjunctivitis in African adults
P Kestelyn1, J Bogaerts, A Meheus
1Department of Ophthalmology, Centre Hospitalier de Kigali, Rwanda, Belgium.
Sexually Transmitted Diseases
|October 1, 1987
Summary
Penicillin-resistant Neisseria gonorrhoeae causes severe adult conjunctivitis and corneal disease. Prompt treatment with spectinomycin or cefotaxime is crucial for preventing vision loss.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Microbiology
Background:
- Adult gonococcal conjunctivitis can lead to severe ocular complications.
- Penicillinase-producing Neisseria gonorrhoeae (PPNG) strains are increasingly prevalent.
- Traditional penicillin treatments are often ineffective against PPNG.
Purpose of the Study:
- To report on six cases of keratoconjunctivitis caused by PPNG in adults.
- To highlight the inadequacy of penicillin in treating these infections.
- To emphasize the need for effective antimicrobial agents to prevent vision-threatening complications.
Main Methods:
- Case series of six adult patients with Neisseria gonorrhoeae keratoconjunctivitis.
- Clinical observation of disease progression and treatment outcomes.
- Microbiologic testing of all N. gonorrhoeae strains for penicillinase production.
Main Results:
- All six cases involved penicillinase-producing N. gonorrhoeae (PPNG).
- Patients treated with penicillin showed continued progression of ocular lesions.
- Treatment with spectinomycin or cefotaxime resulted in disease resolution and microbiologic cure in all patients.
Conclusions:
- Ineffective penicillin treatment contributes to the rising incidence of corneal complications in adult gonococcal conjunctivitis.
- Spectinomycin and cefotaxime are effective alternatives for treating PPNG-related ocular infections.
- Early and appropriate treatment is essential to prevent severe outcomes like corneal ulceration and perforation.