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Gonococcal Conjunctivitis in Adults

Case Report and Retrospective Review of Cases in Alberta, Canada, 2000-2016

Belga, Sara, MD1; Gratrix, Jennifer, MSc2; Smyczek, Petra, MD1,2,3; Lindsay Bertholet, MN2; Read, Ron, MD, PhD4; Roelofs, Kelsey, MD1; Singh, Ameeta, BMBS; MSc1,3

doi: 10.1097/OLQ.0000000000000897
Original Study: PDF Only

Background A case of gonococcal conjunctivitis (GC) prompted us to review the reported cases and treatment regimens of gonococcal conjunctivitis in Alberta, Canada.

Methods Gonococcal cases reported from 2000 to 2016 were extracted from the provincial STI reporting database. The diagnosis of GC was based on a positive culture and/or nucleic acid amplification test from the eye.

Results A total of 45 cases of GC were reported in adults. Three-quarters (75.6%; n=34) of cases were diagnosed using culture, 57.8% (n=26) of cases were among men, and 55.5% (n= 25) were diagnosed since 2014. Very few (13.3%; n=6) of the cases were treated according to current Canadian guidelines on STI, using 2g of ceftriaxone in combination with azithromycin or doxycycline. Results of test of cures were available for 15.6% (n=7) of the cases and occurred within 10 to 79 days (median = 26 days) after treatment; all were negative.

Conclusions GC was relatively uncommon in our region, but given its potential for severe manifestations and sequelae coupled with the rising rates of gonorrhea; it remains important to consider this diagnosis in sexually-active individuals presenting with purulent conjunctivitis. Additional studies are needed to inform treatment recommendations and to evaluate outcomes of infection.

1University of Alberta, Edmonton, Canada;

2STI Centralized Services, Alberta Health Services, Alberta, Canada;

3Edmonton STI Clinic, Alberta Health Services, Edmonton, Canada;

4Calgary STI Clinic, Alberta Health Services, Calgary, Canada

The authors have no conflicts of interest to disclose.

Conflicts of Interest and Source of Funding: None

Corresponding author: Ameeta E. Singh, 3B20 11111-Jasper Ave Edmonton, AB, Canada T5K0L4, Tel: 780 342 2300

Received for publication May 2, 2018, and accepted July 15, 2018.

© Copyright 2018 American Sexually Transmitted Diseases Association