Gonorrheal conjunctivitis: Difference between revisions
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*Usually spread from genital-hand-eye contact in the young sexually active population | *Usually spread from genital-hand-eye contact in the young sexually active population | ||
*Neonates can acquire it from the birth canal | *Neonates can acquire it from the birth canal | ||
==Work-Up== | |||
#Immediate staining for gram-negative diplococci | |||
#Cultures for Neisseria | |||
==Diagnosis== | ==Diagnosis== | ||
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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 | #lid swelling | ||
#globe tenderness through closed lids | |||
#preauricular lymphadenopathy | |||
#May or may not be associated with a urethral discharge. | |||
===Neonates=== | ===Neonates=== | ||
*3-5 days postpartum (bilateral) discharge | *3-5 days postpartum (bilateral) discharge | ||
*May be localized to other organs (arthritis, meningitis, pneumonia) or may be disseminated (sepsis) | |||
==DDx== | ==DDx== | ||
[[Eye Algorithm (Main)]] | [[Eye Algorithm (Main)]] | ||
== | ==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== | ==See Also== | ||
Revision as of 23:13, 30 July 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, pneumonia) or may be disseminated (sepsis)
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]]