Which is the only bacterial conjunctivitis known to cause both (+) preauricular lymphadenopathy and pseudomembranes?

• A. Epidemic Keratoconjunctivitis
• B. Pharyngoconjunctival Fever
• C. Bacterial Conjunctivitis
• D. Gonococcal Conjunctivitis

Answer: (D)

Pseudomembranes form when the conjunctiva undergoes a very intense inflammatory reaction with fibrin-rich exudate, creating a membrane that can be peeled from the surface. When this membrane-forming process occurs with a conjunctival infection that also produces marked preauricular lymph node swelling, the combination is most characteristic of gonococcal conjunctivitis caused by Neisseria gonorrhoeae. This infection is typically hyperacute, with copious purulent discharge and severe inflammation that can lead to pseudomembrane formation and regional lymphadenopathy. Other bacterial causes rarely present with true pseudomembranes, and viruses can cause preauricular nodes but not the membrane formation. Therefore, gonococcal conjunctivitis best explains both findings together.