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Gonococcal keratoconjunctivitis in adults: case report

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Session Details

Session Title: Presented Poster Session: Infection & Imaging

Venue: Poster Village: Pod 2

First Author: : L.Modamio SPAIN

Co Author(s): :    A. Borras   C. Rodriguez   J. Orduña   G. Ancoechea   I. Del Barrio   N. Minguez        

Abstract Details

Purpose:

To present the clinical course and medical management of a patient with bilateral gonococcal keratoconjunctivitis and to highlight the clinical features revealed by anterior segment optical coherence tomography (AS-OCT).

Setting:

Hospital Infanta Cristina Department of Ophthalmology. Madrid, Spain.

Methods:

A 20 year old female was referred to our Department of Ophthalmology diagnosed with acute viral conjunctivitis treated for ten days with Tobramycin-Dexamethasone eye drops with no improvement. The patient presented bilateral eyelid edema, markedly inflamed conjunctiva, purulent exudates, limbitis with superior marginal infiltrates and severe epithelial defect (more than two-thirds) associated, more marked in the left eye. Conjunctival cultures were performed and empirical treatment with oral doxiciclin and topical tobramycin, moxifloxacin and dexamethasone was iniciated. Culture results revealed presence of Neisseria gonorrhoeae sensitive to established treatment so a single dose with 1 gr of intramuscular ceftriaxone was added.

Results:

The patient presented an adequate response to treatment with visual acuity of 20/20 in both eyes, decreased palpebral edema and exudation and progressive re-epithelization of corneal defects that was recorded by (AS-OCT). However, superior corneal thinning in both eyes continued to remain as a sequel even two years after finishing the treatment.

Conclusions:

Conjunctivitis due to N. gonorrhoeae has been considered an uncommon disease in adults in our enviroment, but with the recent increase in sexually transmitted diseases, its incidence has increased. Due to the production of proteolytic enzymes, gonococcal conjunctivitis can progress in a extremely rapid way with corneal thinning leading to corneal perforation and blindness within a few hours-days. It is important to suspect this infection in order to establish the appropriate treatment as quickly as possible to prevent the appearance of serious ocular sequelae.

Financial Disclosure:

None

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