1 - General Pediatric Department, Hospital Dona Estefânia - Unidade Local de Saúde de São José, Lisbon, Portugal
2 - Pediatric Infectious Diseases Department, Hospital Dona Estefânia – Unidade Local de Saúde de São José, Lisbon, Portugal
- Pediatr Infect Dis J [Internet]. 2023;10.1097/INF.0000000000004029. Available from: https://journals.lww.com/pidj/fulltext/9900/gonococcal_conjunctivitis_in_a_10_year_old_.556.a spx DOI: 10.1097/INF.0000000000004029
Background: Gonococcal conjunctivitis (GC) is rare in non-neonatal populations. In children, the most likely cause of transmission is due to sexual abuse. Recommendations for the management of prepubertal gonococcal conjunctivitis are sparse.
Case report: We present the case of a ten-year-old boy, with a 24-hour history of painful edema of the right upper eyelid and hyperpurulent yellow-green discharge. Ocular examination revealed mild conjunctival hyperemia without corneal lesions and no ophthalmoplegia or proptosis. Based on the epidemiology and suspicion of GC, he was started on intravenous ceftriaxone (1 gram) and levofloxacin ophthalmic drops. The ocular discharge culture identified a non-penicillinase-producing strain of N. gonorrhoeae that was susceptible to the treatment. Conjunctival and pharyngeal polymerase chain reaction (PCR) tests were positive for N. gonorrhoeae, with a negative rectal PCR swab and urine, confirming sexual abuse.
Conclusions: We describe this case to highlight the importance of suspecting N. gonorrhoeae infection in the setting of severe conjunctivitis. GC diagnosis in this age group should always lead to suspicion of sexual abuse and all children living in the same household should also be tested.
Palavras Chave: Conjunctivitis, Neisseria gonorrhoeae, prepubertal, sexual abuse