[Gonococcal conjunctivitis complicated by perforating corneal abscess in an adult].

We present a case of bilateral purulent conjunctivitis complicated by ocular perforation of the right eye secondary to fulminant corneal melt in a 29-year-old man. He developed urethritis after a sexual contact with a prostitute 3 weeks previously. Microbiological analyses of conjunctival and urinary cultures were positive for Neisseria gonorrhoeae resistant to penicillins, tetracyclines, and fluoroquinolones. Progression was favorable with a 15-day course of high doses of parenterally administered antibiotics associating imipenem and fosfomycin. Keratoplasty was done after 3 months. This observation is a good example of the problems raised by gonococcal conjunctivitis in adults. Extremely rare in developed countries, it remains widely unrecognized by ophthalmologists. It is a sexually transmitted disease usually resulting from autoinoculation from an infected genital site. The risk of marginal purulent corneal melt, which can lead to fulminant perforation, warrants prompt microbiological analysis and early parenteral antibiotic treatment.