- Presents in the first 4 days of life, usually within 1st 48 hours
- Highly purulent discharge with redness and swelling of the eye lids
- EMERGENCY! Rapidly progressive to corneal ulceration and perforation.
- Diagnosis by gram stain conjunctival scrapings & culture
- Risk for more serious infection-need systemic treatment (other sites can
include: Other sites (scalp abscess, vaginitis, disseminated disease)
- Most common cause of neonatal conjunctivitis.
- Acquired during passage through the birth canal
- Occurs after 4 days to the first several weeks of life
- Bilateral, around 4-10 days after birth
- Initially watery discharge becomes purulent.
- Dx: conjunctival scrapings
- Complications: Pseudomenbranous conjunctivitis.
Ppx: Newborn treatment with silver nitrate (or erythromycin or
tetracycline) is intended to prevent gonococcal ophthalmia. Topical prophylaxis
for gonorrhea has not been confirmed by clinical studies to prevent chlamydia
- SYSTEMIC antibiotics!!!
- Chlamydia: Oral erythromycin for 2 weeks. (topical RX not effective).
Failure rate of 10-20% with Erythromycin often require second course of
- Gonococcal: IV Cefotaxime + topical Erythromycin (ppx silver nitrate,
erythro, or tetracycline)
CHLA Board Review 2005