Neonatal Conjunctivitis

Question 1

Neonatal Conjunctivitis Etiology

Answer 1

1. Bacteria : N.gonorrhea,
   ,C. Trachomatis(most common )
2. Virus:
   HSV
3. Chemical irritation “Chemical conjunctivitis “- due to silver nitrate putted around the umbilicus - usually develop within 24h. of life - self limited in 2 days.

Question 2

If developed , within first 24h. [1st
day] of life..Most likely and treatment

Answer 2

*Chemical conjunctivitis
* tx:Self limited within 2 days

Question 3

If developed after 2- 5 days of life ,Most likely ? , tx?

Answer 3

*N. gonorrhea [Gram – diplococcus]
Charac. by severe purulent
discharge
* tx: 3rd Generation Cephalosporin
[Ceftriaxone]

Question 4

If developed after 5 – 14 days of life Most likely ? and tx?

Answer 4

C. Trachomatis
tx: Azithromycin [Macrolide]

Question 5

If developed After > 14 days Most likely? and Treatment?

Answer 5

**HSV (esophagitis,neonatal conjunctivitis)
-Non purulent discharge
Vesicles !!
tx:Acyclovir(AE:renal failure)

Question 6

Neonatal Conjunctivitis species increase risk for blindness

Answer 6

• HSV , N.gonorrhea , Pseudomonas capable for corneal
  perforation → blindness

**C.Trachomatis DON’T cause corneal disease
→NO blindness !!!

Question 7

Cogan Syndrome

Answer 7

• interstitial keratitis + Auditory vestibular dysfunction [ Tinnitus ,
  hearing loss + vertigo ]

**not conjunctivitis ,it is corneal inflammation)

Question 8

Oral candidiasis

Answer 8

• White cheesy plaques [easily scraped off by spatula]
• At risk: immunocompromised
• Treatment: Nystatin

(* candida esophagitis tx: fluconazole)