ro13-9904 and Conjunctivitis--Bacterial

BACKGROUND Neisseria-associated conjunctivitis is a rare cause of bacterial conjunctivitis in adults, with Neisseria gonorrhoeae as the primarily identified infectious strain. Here, we present a rare case of bacterial conjunctivitis due to Neisseria sicca in a 34-year-old immunocompetent man with no prior medical or ocular history. CASE REPORT A 34-year-old man with no significant past medical or ocular history presented with a 3-day history of left periorbital edema, ocular pain, and copious purulent discharge. Bacterial conjunctivitis was suspected due to the rapidity of onset and purulence. Peripheral corneal thinning was identified. Preliminary culture results showed gram-negative diplococci, and the patient was treated for gonococcal infection. Final cultures identified Neisseria sicca, a rarely pathogenic strain of Neisseria species. CONCLUSIONS This is the second reported case of Neisseria sicca-associated conjunctivitis, and the first reported case to have corneal involvement. Neisseria sicca, while typically non-pathogenic, may manifest as conjunctivitis in immunocompetent hosts with a low-risk sexual history.

Topics: Anti-Bacterial Agents; Ceftriaxone; Conjunctivitis, Bacterial; Humans; Male; Moxifloxacin; Neisseria sicca; Neisseriaceae Infections

Topics: Adolescent; Anti-Bacterial Agents; Ceftriaxone; Coitus; Conjunctivitis, Bacterial; Gonorrhea; Humans; Levofloxacin; Male; Neisseria gonorrhoeae; Orbital Cellulitis; Photophobia; Treatment Outcome

To report the prevalence of gonococcal conjunctivitis (GC) presenting to a tertiary referral maternity hospital (NMH) and a tertiary referral ophthalmic hospital (RVEEH) from 2011 to 2013 and describe the demographics, clinical presentation, and antibiotic susceptibility of Neisseria gonorrhoeae ocular infections.. Demographic, clinical, and microbiological data were collected from patients with laboratory confirmed GC.. There were 27 556 live births at NMH during the study period, and no case of neonatal GC was identified. Fourteen cases of GC were identified at RVEEH in this period, representing a prevalence of 0.19 cases per 1000 eye emergency attendees. Antibiotic susceptibility data were available on nine cases, of which, all were ceftriaxone- and ciprofloxacin sensitive. 64.3% of patients were male, with a mean age of 18 years. The mean duration of symptoms was 3 days. All patients presented with unilateral conjunctival injection and purulent discharge. Eight cases had visual impairment at presentation and their mean visual acuity was 6/15. Corneal involvement was present in 25% of patients. Uveitis was not detected. On receipt of positive culture and/or PCR results, treatment was altered in two thirds of patients. All patients were referred for full STI screening and all patients showed a full clinical recovery 1 week posttreatment.. We observed that GC presented in young adults with a male predominance and was rare in neonates. In cases of unilateral purulent conjunctivitis, there should be a high clinical suspicion of GC, early swab for PCR and culture, and knowledge of current CDC-recommended antibiotic guidelines.

Topics: Adolescent; Anti-Bacterial Agents; Ceftriaxone; Child; Child, Preschool; Ciprofloxacin; Conjunctivitis, Bacterial; Eye Infections, Bacterial; Female; Gonorrhea; Hospitals, Maternity; Hospitals, Special; Humans; Ireland; Male; Microbial Sensitivity Tests; Neisseria gonorrhoeae; Ophthalmia Neonatorum; Ophthalmology; Polymerase Chain Reaction; Prevalence; Young Adult

We present a highly unusual case of microbiologically-confirmed adult gonococcal conjunctivitis in an elderly patient with the absence of genital co-infection and no sexual risk factors. Possible routes of infection are discussed, together with diagnosis and management of gonococcal keratoconjunctivitis. This case serves to highlight the possibility of gonococcal conjunctivitis as a diagnosis in severe, refractory conjunctivitis, even if the patient demographics, lack of pre-existing genital infection or sexual risk factors make gonococcus seem unlikely.

Topics: Aged; Anti-Bacterial Agents; Ceftriaxone; Conjunctivitis, Bacterial; Eye Infections, Bacterial; Gonorrhea; Humans; Male; Microbial Sensitivity Tests; Neisseria gonorrhoeae

Topics: Adolescent; Anti-Bacterial Agents; Ceftriaxone; Conjunctivitis, Bacterial; Diagnosis, Differential; Humans; Male; Neisseria gonorrhoeae

We report a case of severe gonococcal ophthalmia and peri-orbital cellulitis in an HIV-positive man without genital infection who was treated successfully in the outpatient department. We also highlight the importance of early diagnosis, treatment and liaison with ophthalmology in order to prevent visual complications.

Topics: Adult; AIDS-Related Opportunistic Infections; Anti-Bacterial Agents; Ceftriaxone; Conjunctivitis, Bacterial; Gonorrhea; HIV Infections; Humans; Male; Neisseria gonorrhoeae; Treatment Outcome

The authors report 30 chinese patients of ocular Lyme borreliosis, which is a tick-borne spirochaetal disease involving multiple organ systems. The ocular manifestations begin as conjunctivitis, and then as uveitis, choroidoretinitis, keratitis and vitritis. Diagnosis is based on case history and clinical and laboratory findings. Early cases may be cured by oral antibiotics while intravenous drip of large dosage is needed for advanced cases, with a relapsing rate of 16%. Prolonged systemic corticosteroids may predispose the patient to antibiotic failure; however, topical corticosteroids in combination with antibiotics may minimize ocular inflammation and complications.

Topics: Adolescent; Adult; Aged; Borrelia burgdorferi Group; Ceftriaxone; Child; Chorioretinitis; Conjunctivitis, Bacterial; Female; Humans; Lyme Disease; Male; Middle Aged; Penicillins; Uveitis

Topics: Adult; Ceftriaxone; Child; Conjunctivitis, Acute Hemorrhagic; Conjunctivitis, Bacterial; Enterovirus Infections; Humans

Topics: Ceftriaxone; Conjunctivitis, Bacterial; Humans; Male; Meningococcal Infections; Middle Aged; Neisseria; Visual Acuity

We treated 13 consecutive patients with culture proven Neisseria gonorrhoeae conjunctivitis with single-dose intramuscular injections of ceftriaxone. Pretreatment conjunctival cultures and Gram stains were obtained from all patients. The patients were admitted for antibiotic administration, a single conjunctival saline lavage, and follow-up conjunctival cultures six and 12 hours after treatment. Three of 13 organisms (23%) were penicillinase producing. All patients responded to treatment, and all six- and 12-hour posttreatment cultures were negative for N. gonorrhoeae. These results indicate that a single intramuscular dose of ceftriaxone is curative treatment for non-neonatal gonococcal conjunctivitis.

Topics: Adolescent; Adult; Ceftriaxone; Child; Child, Preschool; Conjunctiva; Conjunctivitis, Bacterial; Drug Evaluation; Female; Gonorrhea; Humans; Infant; Injections, Intramuscular; Male; Middle Aged; Neisseria gonorrhoeae; Time Factors