title: Challenges in the management of Neisseria gonorrhoeae keratitis.
abstract: We describe the presentation and subsequent management of a case of keratitis caused by Neisseria gonorrhoeae. A thirty-nine year old gentleman presented with a purulent ocular discharge. Corneal melt with corneal perforation occurred. Neisseria gonorrhoeae was cultured. Systemic and topical antibiotics were given. Deep lamellar keratoplasty was performed for corneal perforation. At three months post treatment no recurrence of infection was noted. The possibility of Neisseria gonorrhoeaea keratitis should always be considered in patients with a purulent ocular discharge even if the case history is not immediately suggestive of the same. Severe gonococcal keratitis may be unilateral. Deep lamellar keratoplasty can be considered as a therapeutic option in patients with severe gonococcal keratitis.
authors.affiliation: Department of Ophthalmology, Waterford Regional Hospital, Waterford, Co. Waterford, Ireland. mcelneaelizabeth@gmail.com.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: McElnea
authors.affiliation: Department of Microbiology, Waterford Regional Hospital, Waterford, Co. Waterford, Ireland.
authors.forename: Patrick
authors.initials: P
authors.lastname: Stapleton
authors.affiliation: Department of Ophthalmology, Waterford Regional Hospital, Waterford, Co. Waterford, Ireland.
authors.forename: Sheryar
authors.initials: S
authors.lastname: Khan
authors.affiliation: Department of Ophthalmology, Waterford Regional Hospital, Waterford, Co. Waterford, Ireland.
authors.forename: John
authors.initials: J
authors.lastname: Stokes
authors.affiliation: Department of Ophthalmology, Waterford Regional Hospital, Waterford, Co. Waterford, Ireland.
authors.forename: Gareth
authors.initials: G
authors.lastname: Higgins
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003315:Cornea / Q000382:microbiology* / Q000473:pathology; D057112:Corneal Perforation / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D016039:Corneal Transplantation; D015818:Eye Infections, Bacterial / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D006069:Gonorrhea / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D007634:Keratitis / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Keratitis; Keratoconjunctivitis; Lamellar keratoplasty; Neisseria gonorrhoeae; Purulent discharge