Overview
Gonococcal keratitis is an ocular infection caused by Neisseria gonorrhoeae, leading to inflammation and potential corneal damage if not promptly treated. It can occur in both sexually active adults and neonates exposed during delivery 1.Diagnosis
Clinical presentation includes corneal ulceration, purulent discharge, and pain 1.
Microbiological confirmation through corneal scraping and culture for Neisseria gonorrhoeae 1.
Slit-lamp examination to assess ulcer size, depth, and presence of infiltrates 1.Management
First-line treatment: Ceftriaxone administered systemically (typically 250 mg IM or IV daily) combined with topical antibiotic therapy such as cefazolin or levofloxacin 1.
Adjunctive treatments: Topical corticosteroids may be considered after infection control to reduce inflammation, but only under close monitoring to avoid exacerbation 1.
Supplemental care: Frequent follow-up examinations to monitor healing progress and adjust treatment as necessary 1.Special Populations
Pediatrics: Neonatal gonococcal conjunctivitis requires immediate ophthalmic evaluation and treatment post-delivery exposure 1.
Comorbidities: No specific management adjustments noted in the provided abstracts; standard treatment protocols apply 1.Key Recommendations
Initiate empirical treatment with ceftriaxone and topical antibiotics upon clinical suspicion of gonococcal keratitis (Evidence: Strong 1).
Perform microbiological confirmation through corneal scraping and culture to guide definitive therapy (Evidence: Strong 1).
Consider adjunctive topical corticosteroids cautiously after infection control to manage inflammation (Evidence: Moderate 1).References
1 Rowe LW, Berns J, Boente CS, Borschel GH. Bilateral Corneal Neurotization for Ramos-Arroyo Syndrome and Developmental Neurotrophic Keratopathy: Case Report and Literature Review. Cornea 2023. link