We report a case of progressive, cephalosporin-susceptible, Neisseria gonorrhoeae conjunctivitis
despite successful treatment of male urethritis syndrome. We hypothesize that conjunctival
infection progressed due to insufficient penetration of cefixime and azithromycin and point out that
extra-genital infection and male urethritis may not be cured simultaneously in settings where the
syndromic approach is used.