Gonococcal conjunctivitis is typically characterized by which finding?

• A. Copious Purulent Discharge with Absence of Preauricular Lymphadenopathy
• B. Watery Discharge with Preauricular Node
• C. Purulent Discharge with Preauricular Node
• D. Watery Discharge with Matted Eyelids

Answer: (A)

Gonococcal conjunctivitis presents with a hyperacute, deeply purulent discharge. The hallmark is copious purulent drainage that often causes the eyelids to stick shut in the morning. Preauricular lymphadenopathy is not a defining feature here, which helps distinguish it from viral conjunctivitis, where preauricular nodes are more commonly seen and the discharge tends to be watery or mucopurulent rather than extremely thick and copious. So the combination of heavy purulent discharge with no preauricular lymphadenopathy best fits this infection, which is also an ophthalmologic emergency requiring prompt systemic antibiotic treatment.