A cross preseptal and postseptal gonococcal orbital cellulitis in a 3-year-old male


  • Trishell Simon Department of Pediatrics, Jackson Memorial Hospital, Miami, Florida, USA http://orcid.org/0000-0003-3638-5128
  • Chanique James Department of Pediatrics, Jackson Memorial Hospital, Miami, Florida, USA




Abuse, Orbital, Cellulitis, Gonococcal, Prepubertal, Nonvenereal


Gonococcal orbital cellulitis is an infrequent presentation within the pediatric age group, with very few cases reported in literature. Even rarer, is the nonvenereal transmission via fomites. Careful physical examination with detailed social evaluation must always be obtained in any child with a gonococcal infection to look for signs or evidence of sexual abuse. This paper reports a 3-year-old male who developed a left preseptal and postseptal gonococcal orbital cellulitis via a nonsexual mode of transmission.


Wan WL, Farkas GC, May WN, Robin JB. The clinical characteristics and course of adult gonococcal conjunctivitis. Am J Ophthalmol. 1986;102(5):575-83.

McAnena L, Knowles SJ, Curry A, Cassidy L. Prevalence of gonococcal conjunctivitis in adults and neonates. Eye (Lond). 2015;29(7):875-80.

Bodurtha Smith AJ, Holzman SB, Manesh RS, Perl TM. Gonococcal Conjunctivitis: A Case Report of an Unusual Mode of Transmission. J Pediatr Adolesc Gynecol. 2017;30(4):501-502.

Price GA, Bash MC. Epidemiology and pathogenesis of Neisseria gonorrhoeae infection. Uptodate.com. Available at: https://www.uptodate.com/ contents/epidemiology-and-pathogenesis-of-neisseria-gonorrhoeae-infection?search=epidem iology-and-pathogenesis1. Accessed on 17 February 2021.

Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance, 2018. Available at: https://www.cdc.gov/std/stats18/tables/21.htm. Accessed on 17 February 2021.

Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2015. Available at: https://www.cdc.gov/std/tg2015/tg-2015-print.pdf. Accessed on 29 January, 2020.

Jenny C, Crawford-Jakubiak JE, Committee on Child Abuse and Neglect, American Academy of Pediatrics. The evaluation of children in the primary care setting when sexual abuse is suspected. Pediatrics. 2013;132(2):558-67.

Azari AA, Barney NP. Conjunctivitis: a systematic review of diagnosis and treatment. JAMA. 2013 Oct 23;310(16):1721-9.

Lewis LS, Glauser TA, Joffe MD. Gonococcal conjunctivitis in prepubertal children. Am J Dis Child. 1990;144(5):546-8.

Raja NS, Singh NN. Bilateral orbital cellulitis due to Neisseria gonorrhoeae and Staphylococcus aureus: a previously unreported case. J Med Microbiol. 2005;54(Pt 6):609-11.

Matters R, Wong I, Mak D. An outbreak of non-sexually transmitted gonococcal conjunctivitis in Central Australia and the Kimberley region. Commun Dis Intell. 1998;22(4):52-6.

Mikru FS, Molla T, Ersumo M, Henriksen TH, Klungseyr P, Hudson PJ, et al. Community-wide outbreak of Neisseria gonorrhoeae conjunctivitis in Konso district, North Omo administrative region. Ethiop Med J. 1991;29(1):27-35.

Centers for Disease Control and Prevention (CDC). Update to CDC's Sexually transmitted diseases treatment guidelines, 2010: oral cephalosporins no longer a recommended treatment for gonococcal infections. MMWR Morb Mortal Wkly Rep. 2012;61(31):590-4.






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