Nersseria gonorrhoeae Keratoconjunctivitis

      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      Clinical and laboratory findings of 47 patients with ocular infections secondary to Neisseria gonorrhoeae during a 5 1/2-year period were reviewed. In 16 patients (34%), corneal involvement was noted. Six of these patients had a severe ulcerative keratitis resulting in permanent visual loss and five required surgery for a corneal perforation. Patients with corneal involvement were older and presented later in the course of their disease than patients with isolated conjunctival involvement ( P < 0.005). An out-patient regimen of intramuscular antibiotics (either penicillin, cephalosporin, or spectinomycin [Trobicin]) appeared to be effective for infections limited to the conjunctiva in adults. If a topical antibiotic ointment is used in addition to parenteral antimicrobial agents, the authors' laboratory sensitivities suggest that erythromycin may be the drug of choice.

      Key words

      To read this article in full you will need to make a payment
      Subscribe to Ophthalmology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

      1. Duke-Elder S System of Ophthalmology. Vol. 8. Part 1. Diseases of the outer eye. CV Mosby Co, St Louis1965: 167-174
        • O'Callaghan CH
        • Morris A
        • Kirby SM
        • Shingler AH
        Novel method for detection of #-lactamase by using a chromogenic cephalosporin substrate.
        Antimicrob Agents Chemother. 1972; 1: 283-288
        • Bauer AW
        • Kirby WM
        • Sherris JC
        • Turck M
        Antibiotic susceptibility testing by a standardized single disk method.
        Am J Clin Pathol. 1966; 45: 493-496
        • Alfonso E
        • Friedland B
        • Hupp S
        • et al.
        Neisseria gonorrhoeae conjunctivitis: an outbreak during an epidemic of acute hemorrhagic conjunctivitis.
        JAMA. 1983; 250: 794-795
        • Spaeth GL
        Treatment of penicillin-resistant gonococcal conjunctivitis with ampicillin.
        Am J Ophthalmol. 1968; 66: 427-429
        • Thatcher RW
        • Pettit TH
        Gonorrheal conjunctivitis.
        JAMA. 1971; 215: 1494-1496
        • Centers for Disease Control
        1985 STD Treatment Guidelines.
        MMWR. 1985; 34: 81-90
        • Leads from the MMWR
        Gonorrhea-United States, 1983.
        JAMA. 1984; 252: 751-753
        • Wan WL
        • Farkas GC
        • May WN
        • Robin JB
        The clinical characteristics and course of adult gonococcal conjunctivitis.
        Am J Ophthalmol. 1986; 102: 575-583
        • Fransen L
        • Nsanze H
        • D'Costa L
        • et al.
        Single-dose kanamycin therapy of gonococcal ophthalmia neonatorum.
        Lancet. 1984; 2: 1234-1236
        • Haase DA
        • Nash RA
        • Nsanze H
        • et al.
        Single-dose ceftriaxone therapy of gonococcal ophthalmia neonatorum.
        Sex Transm Dis. 1986; 13: 53-55
        • Laga M
        • Naamara W
        • Brunham RC
        • et al.
        Single-dose therapy of gonococcal ophthalmia neonatorum with ceftriaxone.
        N Engl J Med. 1986; 315: 1382-1385
        • Thatcher RW
        Gonorrhea.
        in: Fraunfelder FT Roy FH Current Ocular Therapy 2. WB Saunders, Philadelphia1985: 15-16
        • Thatcher RW
        Treatment of acute gonococcal conjunctivitis.
        Ann Ophthalmol. 1978; 10: 445-449
      2. American Academy of Pediatrics. Prophylaxis and treatment of neonatal gonococcal infections.
        Pediatrics. 1980; 65: 1047-1048
        • Frazier JJ
        • Miller J
        • Pickering LK
        Orbital cellulitis due to Neisseria gonorrhoeae in an enucleated socket.
        Arch Ophthalmol. 1979; 97: 2345
        • Wand M
        • Olive GM
        • Mangiaracine AB
        Corneal perforation and iris prolapse due to Mima polymorpha.
        Arch Ophthalmol. 1975; 93: 239-241
        • Mark DB
        • Gaynon MW
        Trauma-induced endophthalmitis caused by Acinetobacter anitratus.
        Br J Ophthalmol. 1983; 67: 124-126
        • Thygeson P
        Marginal corneal infiltrates and ulcers.
        Trans Am Acad Ophthalmol Otolaryng. 1947; 51: 198-209
        • Kenyon KR
        Inflammatory mechanisms in corneal ulceration.
        Trans Am Ophthalmol Soc. 1985; 83: 611-663
        • Schwab L
        • Tizazu T
        Destructive epidemic Neisseria gonorrhoeae keratoconjunctivitis in African adults.
        Br J Ophthalmol. 1985; 69: 525-528
        • Valenton MJ
        • Abendanio R
        Gonorrheal conjunctivitis. Complication after ocular contamination with urine.
        Can J Ophthalmol. 1973; 8: 421-427
        • Brown SI
        • Weller CA
        The pathogenesis and treatment of collagenaseinduced disease of the cornea.
        Trans Am Acad Ophthal Otolaryng. 1970; 74: 375-383
        • Mohos SC
        • Wagner BM
        Damage to collagen in corneal immune injury: observation of connective tissue structure.
        Arch Pathol. 1969; 88: 320
        • Parker AV
        • Williams RN
        • Paterson CA
        The effect of sodium citrate on the stimulation of polymorphonuclear leukocytes.
        Invest Ophthalmol Vis Sci. 1985; 26: 1257-1261
        • Mulks MH
        • Plaut AG
        IgA protease production as a characteristic distinguishing pathogenic from harmless Neisseriaceae.
        N Engl J Med. 1978; 299: 973-975
        • Freeman BA
        Neisseria: the gram-negative pathogenic cocci.
        in: Freeman BA Burrows Textbook of Microbiology. 21 st ed. WB Saunders, Philadelphia1979: 480-499
        • Jones DB
        Pathogenesis of bacterial and fungal keratitis.
        Trans Ophthalmol Soc UK. 1978; 98: 367-371