Gonococcal Conjunctivitis

When gonococcal conjunctivitis occurs, it typically presents in the first few days of life with copius, purulent discharge in the eyes. In this infant, the marked edema of the eyelids was the first symptom noted, but with just slight pressure on the lids, purulent material oozed out (seen here). Unlike the typical "pink eye" conjuncitivitis that occurs in older children, gonococcal conjunctivitis is an ophthalmologic emergency. Because the bacteria can erode through an intact cornea, treatment is very aggressive and includes systemic intravenous antibiotics, frequent eye washes, and monitoring in a neonatal intensive care unit. Fortunately, this diagnosis is very uncommon in places where prophylactic antibiotic eye ointment is used at birth.

photo by Janelle Aby, MD