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Adult Gonococcal Conjunctivitis Complicated by Peripheral Ulcerative Keratitis: A Case Report.

Prashim Sharma¹, Ramesh Bikram Khatri Chhetri², Alisha Adhikari¹

¹Birat Medical College Teaching Hospital Morang Nepal.

Clinical Case Reports

|June 17, 2026

Summary

Adult gonococcal conjunctivitis can cause severe vision loss due to peripheral ulcerative keratitis. Prompt diagnosis, STI screening, and treatment are crucial for saving sight.

Keywords:

Neisseria gonorrhoeae amniotic membrane grafting case report gonococcal conjunctivitis peripheral ulcerative keratitis

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Published on: May 5, 2022

Area of Science:

Ophthalmology
Infectious Diseases
Microbiology

Background:

Neisseria gonorrhoeae conjunctivitis is rare in adults.
It can rapidly lead to severe, vision-threatening complications like peripheral ulcerative keratitis (PUK).

Purpose of the Study:

To report a rare case of adult gonococcal conjunctivitis with PUK.
To highlight the importance of early diagnosis and comprehensive management.

Main Methods:

A case study of a 42-year-old male with bilateral gonococcal conjunctivitis and PUK.
Clinical examination, Gram stain, VDRL, TPHA, and treatment with antibiotics and amniotic membrane grafting.
Syphilis treatment with benzathine penicillin G.

Main Results:

The patient presented with severe conjunctivitis and corneal thinning.
Gram stain confirmed intracellular gram-negative diplococci.
Successful treatment led to vision improvement to 6/9 bilaterally with healed corneas.

Conclusions:

Adult gonococcal conjunctivitis can rapidly progress to PUK.
Early diagnosis, broad STI screening, systemic therapy, and surgical intervention are vital for vision preservation.