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April 1989

Gonococcal Conjunctivitis Mimicking Orbital Cellulitis in a Young Adolescent

Author Affiliations

Department of Emergency Medicine Saint Christopher's Hospital for Children Fifth and Lehigh avenues Philadelphia, PA 19133

Am J Dis Child. 1989;143(4):443-444. doi:10.1001/archpedi.1989.02150160065010

Sir.—Infection by Neisseria gonorrhoeae is the most common reportable disease in the United States.1 Conjunctivitis, however, is a rare manifestation of gonococcal infection beyond the neonatal period.2,3 An outbreak of gonococcal conjunctivitis (GCC), which included some children, has been reported during an epidemic of acute hemorrhagic conjunctivitis, when urine-containing eye drops were used as a folk remedy.4,5 There are few reports of sexually transmitted GCC in adolescents.6 We describe a young adolescent female with GCC who was initially thought to have orbital cellulitis.

Patient Report.—A previously healthy 13-year-old girl developed redness, mild swelling, and discharge from her left eye 2 days before admission. A physician who examined her diagnosed conjunctivitis and prescribed antibiotic eye drops. The eye discharge increased and she developed a burning sensation of the eye, photophobia, and frontal headache. She felt warm, anorexic, fatigued, and nauseated with mild, crampy midabdominal pains.

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