Tistoryview
Disease&Treatment/Cornea&Ocular surfaces
Conjunctivitis and ulcerative keratitis caused by infection with Neisseria gonorrhoeae (Gonococcus)
eye_doc 2025. 4. 21. 23:18👁 “Gonococcal Keratitis – A Rapidly Destructive Corneal Infection”
Neisseria gonorrhoeae, a well-known cause of sexually transmitted infections (STIs),
can cause severe purulent conjunctivitis that, if untreated, may rapidly evolve into ulcerative keratitis and corneal perforation.
🦠 Summary Table of Gonococcal Eye Infection
CategoryDetails
| Clinical Presentation | 🔹 Suppurative conjunctivitis |
| 🔹 Corneal ulceration with risk of perforation | |
| 🔹 Lid edema, hyperemia, anterior chamber inflammation | |
| Age Groups | |
| – Neonates: infection from birth canal → now rare due to prophylaxis | |
| – Adults: autoinoculation from infected genital secretions | |
| Corneal Invasion Mechanism | |
| – Pressure necrosis from pus trapped under eyelid | |
| – Direct cytotoxicity of N. gonorrhoeae | |
| – Inflammatory cell infiltration from limbal vasculature | |
| Treatment Protocol | |
| – Hospital admission recommended | |
| – Ceftriaxone 1g IV/IM x 5 days (in endemic/hyperendemic regions) | |
| – Evaluate for co-infections (Chlamydia, Syphilis) → treat accordingly | |
| Coinfection Management | |
| – Chlamydia: doxycycline, tetracycline, or erythromycin x 7 days |
✅ Clinical Insight
– Corneal perforation is not uncommon with delayed or under-treated cases
– Always test for other STIs
– Treat aggressively and early