Gonorrheal keratoconjunctivitis in African adults.

We describe six cases of keratoconjunctivitis due to Neisseria gonorrhoeae in adults. All strains tested were penicillinase-producing N. gonorrhoeae (PPNG), and we conclude that the rising incidence of corneal involvement, a classic complication in the pre-antibiotic era, is due to ineffective treatment with penicillin. Indeed, the progression of the ocular lesions was stopped and microbiologic cure was obtained in all our patients after treatment with either spectinomycin or cefotaxime. These results demonstrate that early and effective treatment of adult gonococcal conjunctivitis is mandatory to avoid potentially blinding complications such as corneal ulceration and perforation of the eye.