Case Report January 21, 2026 January 21, 2026

Severe keratitis secondary to gonococcal conjunctivitis

DOI: 10.37039/1982.8551.20260002

ABSTRACT

The objective of this study is to report a case of complicated gonococcal conjunctivitis with keratitis. A patient presented to the ophthalmologic emergency department of the Clinical Hospital at the Federal University of Minas Gerais with purulent discharge from the right eye, ocular hyperemia, pain, and low visual acuity that had started 2 days before. An ophthalmologic examination revealed a visual acuity of counting fingers to face in the right eye. Biomicroscopy revealed purulent discharge, ocular hyperemia, chemosis and extensive keratitis. The diagnostic hypothesis of complicated gonococcal conjunctivitis with keratitis with an imminent risk of perforation was raised. Samples were collected for bacterioscopy and cultures. The patient was hospitalized and prescribed ciprofloxacin eye drops every 1 hour, ceftriaxone 1 g intravenously every 12 hours for 3 days and azithromycin 1 g orally. The culture result confirmed the diagnosis. After 1 month of follow-up, the patient returned with no pain complaints but maintained low visual acuity in the right eye. Biomicroscopy showed a cornea with a large cicatricial leukoma area. Early recognition and treatment of this pathology are the essential for improving visual prognosis and functional rehabilitation.