TAILIEUCHUNG - Chapter 137. Gonococcal Infections (Part 5)

Ocular Gonorrhea in Adults Ocular gonorrhea in an adult usually results from autoinoculation from an infected genital site. As in genital infection, the manifestations range from severe to occasionally mild or asymptomatic disease. The variability in clinical manifestations may be attributable to differences in the ability of the infecting strain to elicit an inflammatory response. Infection may result in a markedly swollen eyelid, severe hyperemia and chemosis, and a profuse purulent discharge. The massively inflamed conjunctiva may be draped over the cornea and limbus. Lytic enzymes from the infiltrating PMNs occasionally cause corneal ulceration and rarely cause perforation. Prompt recognition and. | Chapter 137. Gonococcal Infections Part 5 Ocular Gonorrhea in Adults Ocular gonorrhea in an adult usually results from autoinoculation from an infected genital site. As in genital infection the manifestations range from severe to occasionally mild or asymptomatic disease. The variability in clinical manifestations may be attributable to differences in the ability of the infecting strain to elicit an inflammatory response. Infection may result in a markedly swollen eyelid severe hyperemia and chemosis and a profuse purulent discharge. The massively inflamed conjunctiva may be draped over the cornea and limbus. Lytic enzymes from the infiltrating PMNs occasionally cause corneal ulceration and rarely cause perforation. Prompt recognition and treatment of this condition are of paramount importance. Gram s stain and culture of the purulent discharge establish the diagnosis. Genital cultures should also be performed. Gonorrhea in Pregnant Women Neonates and Children Gonorrhea in pregnancy can have serious consequences for both the mother and the infant. Recognition of gonorrhea early in pregnancy also identifies a population at risk for other STIs particularly chlamydial infection and syphilis. The risks of salpingitis and PID conditions associated with a high rate of fetal loss are highest during the first trimester. Pharyngeal infection most often asymptomatic may be more common during pregnancy because of altered sexual practices. Prolonged rupture of the membranes premature delivery chorioamnionitis funisitis infection of the umbilical cord stump and sepsis in the infant with N. gonorrhoeae detected in the newborn s gastric aspirate during delivery are common complications of maternal gonococcal infection at term. Other microorganisms and conditions including Mycoplasma hominis Ureaplasma urealyticum C. trachomatis and bacterial vaginosis have been associated with similar complications. The most common form of gonorrhea in neonates is ophthalmia neonatorum which .

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