ABSTRACT
PURPOSE: 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. METHODS: Demographic, clinical, and microbiological data were collected from patients with laboratory confirmed GC. RESULTS: 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. CONCLUSION: 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.
Subject(s)
Conjunctivitis, Bacterial/epidemiology , Eye Infections, Bacterial/epidemiology , Gonorrhea/epidemiology , Neisseria gonorrhoeae/isolation & purification , Ophthalmia Neonatorum/diagnosis , Ophthalmia Neonatorum/epidemiology , Adolescent , Anti-Bacterial Agents/therapeutic use , Ceftriaxone/therapeutic use , Child , Child, Preschool , Ciprofloxacin/therapeutic use , Conjunctivitis, Bacterial/diagnosis , Conjunctivitis, Bacterial/drug therapy , Eye Infections, Bacterial/diagnosis , Eye Infections, Bacterial/drug therapy , Female , Gonorrhea/diagnosis , Gonorrhea/drug therapy , Hospitals, Maternity/statistics & numerical data , Hospitals, Special/statistics & numerical data , Humans , Ireland/epidemiology , Male , Microbial Sensitivity Tests , Neisseria gonorrhoeae/drug effects , Ophthalmia Neonatorum/drug therapy , Ophthalmology/statistics & numerical data , Polymerase Chain Reaction , Prevalence , Young AdultABSTRACT
INTRODUCTION: A case of an 11-year-old boy presenting with a two-week history of a red, irritated right eye after handling a Chilean Rose Tarantula at an exotic pet exhibition. Examination revealed innumerable microscopic hairs embedded at all levels of the cornea. He was commenced on steroid drops with subjective and objective improvement at follow up. DISCUSSION: Tarantulas use their urticating abdominal hairs as a defense mechanism by flicking them into attackers' eyes and skin, causing intense irritation. Ocular complications ranging from simple conjunctivitis, through to keratouveitis and even pan-uveitis with chorioretinitis, have been described in the literature. As exotic pets become more popular, the importance of wearing ocular protection when handling tarantulas should be stressed.