Between June 1985 and December 1988, 58 cases of gonococcal ophthalmia neonatorum were admitted to the neonatal unit at the University Hospital (USM). Of these, 15 (25.9%) cases were due to penicillin-resistant strains of Neisseria gonorrhoea. Of the 58 cases, 56 cases were treated effectively with a single dose of antibiotic given systemically. The mean period of recovery was shorter with spectinomycin in doses of 40 mg/kg than with cefotaxime (100 mg/kg). There was no permanent sequelae in the treated cases. An increasing incidence of infection with penicillin-resistant strains of N. gonorrhoea has been observed in the area of study.
We report a case of acute gonococcal conjunctivitis in a 36-year-old woman who presented with eye redness and a history of discharge for one month. Prior to presenting to us, she was treated for bacterial conjunctivitis with three courses of local antibiotics by three different clinics after brief assessments and without improvement. The final diagnosis of gonococcal conjunctivitis was made after a complete history was elicited and supported by the presence of Neisseria Gonorrhoeae in the eye swab culture test. She and her sexual partner were treated successfully with intramuscular Ceftriaxone and oral Azithromycin. This case highlights the importance of complete history taking, including sexual history, which translates into early recognition and treatment, thus preventing complications.
We report a case of acute gonococcal conjunctivitis in a 36-year-old woman who presented with
eye redness and a history of discharge for one month. Prior to presenting to us, she was treated for
bacterial conjunctivitis with three courses of local antibiotics by three different clinics after brief
assessments and without improvement. The final diagnosis of gonococcal conjunctivitis was made
after a complete history was elicited and supported by the presence of Neisseria Gonorrhoeae in
the eye swab culture test. She and her sexual partner were treated successfully with intramuscular
Ceftriaxone and oral Azithromycin. This case highlights the importance of complete history taking,
including sexual history, which translates into early recognition and treatment, thus preventing
complications. (Copied from article).
Ophthalmia neonatorum remains a significant cause of ocular morbidity, blindness and even death in underdeveloped countries. The organisms causing ophthalmia neonatorum are acquired mainly from the mother's birth canal during delivery and a small percentage of cases are acquired by other ways. Chlamydia and Neisseria are the most common pathogens responsible for the perinatal infection. Fortunately in most cases, laboratory studies can identify the causative organism and unlike other form of conjunctivitis, this perinatal ocular infection has to be treated with systemic antibiotics to prevent systemic colonization of the organism. Routine prophylaxis with 1% silver nitrate solution (credes method) has been discontinued in many developed nations for the fear of development of chemical conjunctivitis.