Gonorrheal conjunctivitis: Difference between revisions
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#Copious purulent discharge (reforms quickly after wiping away) | #Copious purulent discharge (reforms quickly after wiping away) | ||
#Marked conjunctival injection/chemosis | #Marked conjunctival injection/chemosis | ||
# | #Lid swelling | ||
# | #Globe tenderness through closed lids | ||
# | #Preauricular lymphadenopathy | ||
#May or may not be associated with a urethral discharge. | #May or may not be associated with a urethral discharge. | ||
===Neonates=== | ===Neonates=== | ||
*3-5 days postpartum | *3-5 days postpartum | ||
*May be localized to other organs (arthritis, meningitis, | *Bilateral) discharge | ||
*May be localized to other organs (arthritis, meningitis, PNA) or may be disseminated | |||
==DDx== | ==DDx== | ||
Revision as of 18:19, 25 October 2011
Background
- Caused by Neisseria gonorrhoeae
- Usually spread from genital-hand-eye contact in the young sexually active population
- Neonates can acquire it from the birth canal
Work-Up
- Immediate staining for gram-negative diplococci
- Cultures for Neisseria
Diagnosis
- Abrupt onset
- Copious purulent discharge (reforms quickly after wiping away)
- Marked conjunctival injection/chemosis
- Lid swelling
- Globe tenderness through closed lids
- Preauricular lymphadenopathy
- May or may not be associated with a urethral discharge.
Neonates
- 3-5 days postpartum
- Bilateral) discharge
- May be localized to other organs (arthritis, meningitis, PNA) or may be disseminated
DDx
Treatment
- Eye irrigation (saline)
- Topical antibiotics
- same as for Bacterial Conjunctivitis
- Systemic antibiotics for Gonorrhea
- Urgent referral to ophtho
Disposition
- Infant=Admit?
- Adult=Discharge
- Unless evidence of complication or immunodeficiency
Complications
- Ulceration
- Perforation
See Also
Source
Mahmood AR, Narang AT. Diagnosis and management of the acute red eye. Emerg Med Clin N Am. 2008;26:35-55. [{Category:ID]]