title: Gonococcal Conjunctivitis: A Case Report of an Unusual Mode of Transmission.
abstract: BACKGROUND
  Outside of the newborn period, development of gonococcal conjunctivitis is rare and predominantly occurs through autoinoculation. We report an unusual case of gonococcal conjunctivitis in a young woman exposed through direct inoculation.
  
  
  METHODS
  A 19-year-old woman presented with purulent ocular discharge, severe pain, and decreased vision unresponsive to topical antibiotics or ganciclovir approximately 3 weeks after accidental ocular exposure to seminal fluid during unprotected oral sex. Cultured ocular drainage grew Neisseria gonorrhea; vaginal and throat cultures were negative. She was successfully treated with ceftriaxone and doxycycline for 10 days.
  
  
  CONCLUSIONS
  Clinicians should be aware of the potential for vision-threatening gonococcal conjunctivitis from exposure during sexual contact.
authors.affiliation: Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland. Electronic address: asmit230@jhmi.edu.
authors.forename: Anna Jo
authors.initials: AJ
authors.lastname: Bodurtha Smith
authors.affiliation: Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Samuel B
authors.initials: SB
authors.lastname: Holzman
authors.affiliation: Department of Medicine, Division of Hospital Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Reza Sedighi
authors.initials: RS
authors.lastname: Manesh
authors.affiliation: Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Trish M
authors.initials: TM
authors.lastname: Perl
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003234:Conjunctivitis, Bacterial / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D006069:Gonorrhea / Q000175:diagnosis* / Q000188:drug therapy / Q000635:transmission; D006801:Humans; D007231:Infant, Newborn; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification*; D012725:Sexual Behavior; D047568:Unsafe Sex
chemical_list: D000900:Anti-Bacterial Agents
keywords: Adolescent; Conjunctivitis; Female; Gonorrhea; Oral sex; Sexually transmitted infection