부산대학교 도서관

Purpose: A case report of ocular perforation secondary to gonococal queratoconjunctivitis is presented. Methods: A 49 year old man visited the Emergency Departement with redness, pain, and purulent secretion in his left eye of four days of evolution. He related a risky sexual relationship in the days before the clinic appeared, with direct inoculation of vaginal secretions in his left eye. At the slit lamp examination, he presented a significant corneal thining with ocular perforation in the upper part of the cornea. The direct microscopic examination of ocular secretions showed the presence of gram negative diplococci.Treatment with intravenous ceftriaxone, and topic ceftazidime was instaured. The patient underwent an urgent surgical intervention with a superior conjunctival covering of the upper of the cornea. Results: The evolution of the patient was favorable with surgical treatment and antibiotic therapy. The results of the culture of ocular secretions confirmed the growth of Neisseria gonhorreae. One month later, the patient underwent a penetranting keratoplasty and a phacoemulsification with intraocular lens implant in the posterior chamber. At the moment, the patient is stable without corneal reject signs and a visual acuity of 1/10 with his left eye. Conclusion: Gonococal queratoconjunctivitis is a serious infection that can cause significant corneal thining and ocular perforation. The incidence of this disease has increasead in the last years. For this reason it is important to make a differential diagnosis in presence of purulent queratoconjunctivitis asociated with risk factors. [ABSTRACT FROM AUTHOR]