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July 17, 1981

Ocular Gonococcal Infection With Minimal or No Inflammatory Response

Author Affiliations

From the Departments of Pediatrics and Pathology, Madigan Army Medical Center, Tacoma, Wash (Dr Podgore); and the Department of Medicine, University of Washington and United States Public Health Service Hospital, Seattle (Dr Holmes).

JAMA. 1981;246(3):242-243. doi:10.1001/jama.1981.03320030034023

THE SEVERITY and complications of ocular gonococcal infection are well recognized. The incubation period in neonates is one to three days, with the appearance of a profuse purulent conjunctival discharge accompanied by marked edema and hyperemia of the eyelids1 by five days after exposure. Cases with incubation periods up to 19 days have been reported after inoculation of the eye with urine contaminated by gonococci, but a marked exudative response occurred with the onset of symptoms.2 Rapid diagnosis and treatment are thought essential to prevent serious ocular damage. The conjunctival inflammatory reaction may be complicated by extension and penetration into the corneal epithelium. Corneal involvement has been regarded as a common feature of untreated cases.

There has been increasing evidence that Neisseria gonorrhoeae may colonize the genital tract, anal canal, and oropharynx without producing symptoms or signs of inflammation. However, ocular gonococcal infection or colonization with minimal or