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2023

ANUÁRIO DO HOSPITAL
DONA ESTEFÂNIA

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PEDIATRIC GONOCOCCAL CONJUNTIVITIS: ALTERNATIVE WAYS OF TRANSMISSION

Andreia Luis Martins1, Catarina Gouveia2, Maria João Brito2

1Department of Pediatrics; Head of Department: Helena Carreiro, Hospital Prof. Doutor Fernando Fonseca, E.P.E.
2Department of Pediatric Infectious Diseases; Head of Department: Gonçalo Cordeiro Ferreira, Hospital Dona Estefânia, Centro Hospitalar de Lisboa Central, E.P.E.

-     Poster no 32nd Annual Meetting of the European Society for Paediatric Infectious Diseases. Dublin, 6-10 de Maio de 2014

BACKGROUND AND AIMS Gonococcal conjunctivitis (GC) is a highly contagious eye infection caused by Neisseria gonorrhoeae. Childhood infection occurs mainly in newborns (vertical transmission) and children/adolescents (non-intimate interpersonal contact, contact with infected fomites and sexual contact/abuse). This study aims to determine the epidemiology of GC in pediatric units of a European country, calling attention to less known modes of transmission.
METHODS Descriptive study of children admitted with GC in two pediatric units in a 12-year period. Clinical charts and exudate bacterial cultures were consulted. Clinics, age, parents’ origin, source and mode of transmission were evaluated.
RESULTS Seven reports were assessed; 3 newborns; 3 children between 12 and 24 months and a child aged 8; 6/7 had African origin. The clinical diagnoses were conjunctivitis (3) and orbital cellulitis (4). All were transmitted by a close relative (mother-57%). Regarding mode of transmission, 3 had vertical transmission, 1 was through infected fomites, 1 through non-intimate interpersonal contact and in 2 through eye urine irrigation as an ethnic traditional purpose. No cases of sexual transmission were found. All children were treated with parenteral ceftriaxone with no sequelae.
CONCLUSIONS GC can occur in young children. Unlike gonococcal infection at other location, a non-sexual mode of transmission can occur. Still, signs of sexual abuse should always be excluded. Also, prevention of alternative modes of transmission should be emphasized. These occur mainly among African immigrants who live in crowded habitations with poor hygiene conditions or may have ethnic traditional practices (eye urine irrigation).