III. Signs

  1. Profuse purulent exudate ("waterfall of pus")
  2. Profound lid edema
  3. Chemosis
  4. Corneal Ulceration
  5. Occurs in newborns within 24-48 hours of birth

IV. Management: Newborns

  1. General Measures
    1. Frequent saline Eye Irrigation until no discharge
    2. Treat mother and partners for Gonorrhea and Chlamydia
    3. Treat newborn also for Chlamydia Conjunctivitis
  2. Antibiotic
    1. Ceftriaxone (Rocephin) 25 to 50 mg/kg up to 250 mg IV/IM x1 dose (preferred) OR
    2. Cefotaxime (Claforan) 100 mg/kg IV/IM x1 dose
  3. Alternative if Penicillin senstive (not typically used)
    1. Penicillin G 100,000 units/kg/day IV qid for 7 days

V. Management: Adults

  1. Concurrently treat Chlamydia (e.g. Azithromycin 1 g orally once)
  2. Gonorrhea management
    1. Ceftriaxone 250 mg IV or IM for 1 dose AND
    2. Ciprofloxacin eye ointment 4x/day AND
    3. Saline Eye Irrigation 4x/day

VI. Complications

  1. Corneal perforation (high risk)

VII. References

  1. Williams (2017) Crit Dec Emerg Med 31(2): 3-12
  2. Yanoff (1999) Ophthalmology, Mosby, p. 1.7
  3. Fuloria (2002) Am Fam Physician 65(1):61-8 [PubMed]

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Ontology: Gonococcal conjunctivitis (C0339166)

Concepts Disease or Syndrome (T047)
ICD10 A54.31
SnomedCT 231858009
English GONOCOCCAL CONJUNCTIVITIS, gonococcal conjunctivitis (diagnosis), gonococcal conjunctivitis, conjunctivitis gonococcal, gonococcal ophthalmia, Gonococcal conjunctivitis, Gonococcal conjunctivitis (disorder), Gonococcal ophthalmia
Spanish conjuntivitis gonocócica (trastorno), conjuntivitis gonocócica