Case history
Case history #1
A 6-year-old girl with no significant past medical history presents 4 days after developing a red, irritated left eye. Her mother states that she has been wiping thick whitish-yellow discharge from her eye, and the eye is matted shut in the morning. She denies any exposure to a sick contact, upper respiratory symptoms, or contact lens use. She also denies any significant pain or light sensitivity. On examination, the patient's pupils are equal and reactive. She does not have a tender preauricular lymph node. Penlight examination does not reveal any corneal opacity, but thick, whitish discharge is seen.
Case history #2
A 14-year-old boy with no significant past medical history presents 3 days after developing a red, irritated right eye that spread to the left eye today. He has watery discharge from both eyes and they are stuck shut in the morning. He reports recent upper respiratory symptoms and that several children at his day camp recently had pink eye. He denies significant pain or light sensitivity and does not wear contact lenses. On examination, his pupils are equal and reactive and he has a right-sided, tender preauricular lymph node. Penlight examination does not reveal any corneal opacity.
Other presentations
Hyperacute presentation over 24-48 hours with copious whitish-yellow discharge in a sexually active person is consistent with Neisseria gonorrhoeae, unless shown otherwise. Allergic conjunctivitis is typically bilateral with itching and a ropy or watery discharge.[Figure caption and citation for the preceding image starts]: Gonococcal conjunctivitisCDC Image Library/Joe Miller; used with permission [Citation ends].
[Figure caption and citation for the preceding image starts]: Gonococcal conjunctivitis: resulted in partial blindnessCDC Image Library; used with permission [Citation ends].
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