This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in

Gonorrhoea (congenital)

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Seek expert advice.

  • congenital gonorrhoea infection is acquired intrapartum, and it leads to ophthalmia neonatorum
  • gonococcal ophthalmia neonatorum presents with a severe conjunctivitis and keratitis usually in the first 48 hours of life. There may be purulent discharge. If untreated blindness may result. It is frequently bilateral (1)
  • also, there can be disseminated neonatal gonorrhoea infection
  • diagnosis is by Gram stain smear and culture of conjunctival discharge
  • treatment involves both topical (e.g. chloramphenicol eye ointment) and intramuscular benzylpenicillin. In view of increasing antimicrobial resistance, the following alternative options may need to be considered (2):
    • ceftriaxone IV or IM as a single dose OR
    • cefotaxime as a single dose
  • frequent conjunctival irrigation with saline is recommended (2)
  • both parents of the child should also be assessed
  • ocular prophylaxis is no longer routinely administered in the UK, though it is still given in parts of the USA and third world where incidence rates are higher.
  • in cases where the infant is born to those with known gonorrhoea then prophylactic treatment IM benzylpenicillin 30mg/kg stat and chloramphenicol eye ointment is initiated within the first hour after birth

A review suggests (3):

  • consider neonatal conjunctivitis in all infants presenting with eye discharge within the first 4 weeks of life
  • carefully examine the conjunctiva: if red, refer to hospital eye services for same day review
    • NICE recommends urgent referral to ophthalmology for all cases of "sticky eye with redness in a neonate"

  • investigations and treatment for suspected neonatal conjunctivitis in primary care are not necessary and may interfere with subsequent microbiology sampling

  • eye discharge with normal conjunctiva is likely due to congenital nasolacrimal duct obstruction

Reference:


Related pages

Create an account to add page annotations

Add information to this page that would be handy to have on hand during a consultation, such as a web address or phone number. This information will always be displayed when you visit this page

The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

Connect

Copyright 2024 Oxbridge Solutions Limited, a subsidiary of OmniaMed Communications Limited. All rights reserved. Any distribution or duplication of the information contained herein is strictly prohibited. Oxbridge Solutions receives funding from advertising but maintains editorial independence.