Gonococcal Conjunctivitis

Copious muco-purulent discharge. Gonococcal conjunctivitis is an ophthalmic emergency — it can cause corneal ulceration and perforation.

Diagnosis

Swab for Gram stain and PCR for Neisseria gonorrhoeae. If suspected clinically, treat empirically without waiting for culture results.

Management

• IM ceftriaxone 1 g (50 mg/kg) plus azithromycin 1 g (20 mg/kg)
• Seek ophthalmology assistance — refer immediately if corneal opacity develops
• Evaluate the patient for other sites of infection (genital, pharyngeal, rectal — see sti-screening.md and the mens-health/womens-health STI pages)