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Adult gonococcal conjunctivitis: Prevalence, clinical features and complications
Genoveva Cuesta Chasco1, Xavier Carreras-Castañer2, Yuliya Zboromyrska1
1Department of Microbiology, Hospital Clínic Barcelona, Barcelona, Spain.
Journal of Medical Microbiology
|September 8, 2021
Summary
Adult gonococcal conjunctivitis (AGC) is a rare but serious complication of gonorrhea. Early diagnosis and prompt treatment are crucial to prevent severe corneal damage and vision loss, especially with rising antibiotic resistance.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Microbiology
Background:
- Gonorrhea incidence is rising globally.
- Adult gonococcal conjunctivitis (AGC) is an uncommon but potentially sight-threatening complication.
- Early and accurate diagnosis of AGC is essential to prevent severe ocular morbidity.
Purpose of the Study:
- To determine the prevalence, clinical characteristics, and complications of AGC.
- To analyze antibiotic susceptibility patterns of Neisseria gonorrhoeae in AGC cases.
- To highlight the importance of timely and appropriate management in a tertiary ophthalmology center.
Main Methods:
- Retrospective case series of microbiologically confirmed AGC cases (2012-2020).
- Analysis of clinical presentation, treatments, and ocular sequelae.
- Evaluation of antibiotic susceptibility, including resistance to ciprofloxacin and beta-lactamase production.
Main Results:
- Thirteen AGC cases were identified, mostly unilateral (11/13).
- Common symptoms included abundant mucopurulent discharge; some cases mimicked orbital cellulitis.
- All strains were susceptible to ceftriaxone; 58% showed ciprofloxacin resistance. One patient developed ptosis due to symblepharon.
Conclusions:
- AGC is rare, challenging to diagnose, and requires a high index of suspicion.
- Prompt treatment is critical to prevent corneal perforation and other serious complications.
- Complete treatment, potentially with azithromycin or aminoglycoside eye drops, is vital due to quinolone resistance.
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