Gonococcal Keratoconjunctivitis in Adult.

Kim, Hyun Kyu; Lee, Jong Soo; Lee, Ju Rak

Case Report

Journal of the Korean Ophthalmological Society 2002;43(4):786-790.
Published online April 1, 2002.

Gonococcal Keratoconjunctivitis in Adult.

¹Department of Ophthalmology, College of Medicine, Pusan National University, Pusan, Korea. jongsool@hyowon.pusan.ac.kr
²Mirae Eye Center, Korea.

성인에서 각막염을 동반한 임균성 결막염 1예

김현규 ( Kim Hyun Kyu ) , 이종수 ( Lee Jong Soo ) , 이주락 ( Lee Ju Rak )

Abstract

PURPOSE
Neisseria gonorrhea is usually identified in neonatal conjunctivitis, but rare in adult keratoconjunctivitis. We report a rare case of bilateral gonococcal conjunctivitis combined with keratitis. METHODS: A 29-year-old male with a history of sexual contact with a prostitute 17 days ago referred to our hospital with acute keratoconjunctivitis. Ocular discharge was examined by Gram stain, culture, and sensitivity test to antibiotics, resulting in the identification of penicillin-resistant Neisseria gonorrhea. RESULTS: This patient was treated with intramuscular ceftriaxone for 5 days and topical cefmenoxime 0.5% for 2 weeks. Following 24 hours after antibiotics medication, the clinical symptoms were improved, and follow-up culture was negative. No evidence of serious complication was left in the cornea and conjunctiva. CONCLUSIONS: As adult gonococcal keratoconjuctivitis is relatively rare, the clinical diagnosis may be delayed. When one suspects an adult gonococcal keratoconjunctivitis, immediate gram staining and confirmatory culture for isolation of gram-negative intracellular diplococci are mandatory. It should be remembered that intramuscular ceftriaxone and topical cefmenoxime are an effective treatment for this condition.

Key Words: Cefmenoxime (Bestron R );Ceftriaxone (Rocephin R );Gonococcal keratoconjunctivitis;Penicillin-resistant Neisseria gonorrhea