Corneal perforation due to gonococcal infection

Hartawan Tjahjadi Putra, Rosy Aldina

Abstract


INTRODUCTION : Neisseria gonorrhoeae is the second largest cause of sexually transmitted infections (STIs). Its ophthalmic manifestation in cornea can cause sight-threatening condition, scarring and possible corneal perforation. This study is reporting a rare case of corneal perforation due to infection of Neisseria gonorrhoeae.

METHOD : Diagnosis was made based on history taking, ophthalmology examination, microbiology test.

RESULTS : 22-year-old male came to ophthalmology emergency service of Dr. Saiful Anwar Hospital Malang complaining of redness and eyelid swelling on left eye since 1 week prior to visit accompanied by thick purulent discharge and blurred vision. Visual acuity was 20/20 on right eye and light perception bad projection on left eye. The examination of anterior segment showed eyelid swelling, conjunctival injection, severe mucopurulent discharge, central corneal epithelial-stromal defect and stromal infiltrate with microperforation. A sample of corneal swab was sent for microbiology examination and showed gram-negative diplococci. Patient was admitted and received systemic and topical antibiotic. Widespread epithelial defect and vitreous prolapse was found on the second day. Patient refused evisceration and was follow-ups right after requesting discharge against medical service.

CONCLUSION : Ocular infection of Neisseria gonorrhoeae is rare but the damage is rapidly progressive which can lead to corneal perforation. There should not be delay in treatment of suspicious case of purulent conjunctivitis.


Keywords


Neisseria gonorrhoeae, gram-negative dipplococci, corneal perforation, purulent conjunctivitis, ocular gonorrhoeae.

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References


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