Gonococcal Conjunctivitis: A Case Report of an Unusual Mode of Transmission

Abstract

Background: Outside of the newborn period, development of gonococcal conjunctivitis is rare and predominantly occurs through autoinoculation. We report an unusual case of gonococcal conjunctivitis in a young woman exposed through direct inoculation.

Case: A 19-year-old woman presented with purulent ocular discharge, severe pain, and decreased vision unresponsive to topical antibiotics or ganciclovir approximately 3 weeks after accidental ocular exposure to seminal fluid during unprotected oral sex. Cultured ocular drainage grew Neisseria gonorrhea; vaginal and throat cultures were negative. She was successfully treated with ceftriaxone and doxycycline for 10 days.

Summary and conclusion: Clinicians should be aware of the potential for vision-threatening gonococcal conjunctivitis from exposure during sexual contact.

Keywords: Adolescent; Conjunctivitis; Female; Gonorrhea; Oral sex; Sexually transmitted infection.