Povidone-Iodine as an Adjuvant Therapy for Refractory Gonorrhea Keratoconjunctivitis: A Case Report

Gonorrhea keratoconjunctivitis is a sight-threatening condition that requires hospitalization and systemic antibiotic therapy. We report a case of a 47-year-old man suffering from gonococcal conjunctivitis with progressive corneal involvement despite three days of appropriate topical and intravenous antibacterial therapy. The patient received adjuvant treatment with 5% topical povidone-iodine, which had an immediate beneficial effect. One day after the application, the patient showed a resolution of severe exudative discharge with improvement in epithelial defects and thinning. By hospital day seven, the corneal defect and thinning had both resolved. Povidone-iodine may be a low-cost, safe, and potentially effective adjuvant therapy for refractory gonococcal keratoconjunctivitis in adult individuals unresponsive to standard-of-care antibiotic therapy after 72 hours of treatment. However, there is no evidence to support povidone-iodine as a standalone treatment for gonococcal conjunctivitis. Further research with a greater number of patients is needed to determine its true utility.