Introduction:

Gonococcal conjunctivitis is a severe eye infection caused by Neisseria gonorrhoeae, the bacterium responsible for the sexually transmitted infection gonorrhea. This type of conjunctivitis can occur in adults and newborns (ophthalmia neonatorum) and requires prompt medical attention due to its potential to cause serious complications, including vision loss.

Causes:

• In adults, typically transmitted through contact with infected genital secretions, often related to sexual activity.
• In newborns, can occur during childbirth if the mother has an untreated gonorrheal infection.

Symptoms:

• Rapid onset of eye redness and swelling.
• Purulent (pus-like) discharge from the eyes, which is often copious and yellow-green.
• Eyelid swelling and tenderness.
• Sensitivity to light (photophobia).
• In severe cases, corneal involvement may lead to ulceration and perforation, risking permanent vision loss.

Diagnostic Evaluation:

• Clinical evaluation based on symptoms and patient history.
• Laboratory confirmation by taking a swab of the conjunctival discharge and performing bacterial culture or nucleic acid amplification tests (NAATs).
• For newborns, maternal sexually transmitted infection (STI) history is also considered.

Treatment and Management:

• Prompt antibiotic therapy is crucial. Typically, intravenous or intramuscular antibiotics, such as ceftriaxone, are administered.
• In cases of corneal involvement, hospitalization and ophthalmology consultation are necessary.
• Sexual partners must be evaluated and treated to prevent reinfection.
• Newborns with gonococcal conjunctivitis require systemic antibiotic treatment and close monitoring.

Prevention:

• Safe sex practices, including the use of condoms, to reduce the risk of gonococcal infection.
• Screening and appropriate treatment for gonorrhea during pregnancy to prevent ophthalmia neonatorum.
• Prophylactic eye treatment for all newborns to prevent bacterial conjunctivitis, as recommended in many countries.

Complications:

• If left untreated, can lead to corneal perforation and blindness.
• Potential systemic spread of the infection, leading to disseminated gonococcal infection.

Conclusion:

Gonococcal conjunctivitis is a serious eye infection that requires immediate medical intervention to prevent severe complications. Early diagnosis, effective antibiotic treatment, and preventive measures are critical for managing this condition and safeguarding ocular and overall health.

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