Neonatal conjunctivitis - Revision history

Rossdonaldson1: /* +External Links= */

2026-02-04T18:16:02Z

+External Links=

← Older revision		Revision as of 18:16, 4 February 2026
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	{{Eye algorithms}}		{{Eye algorithms}}

	=+External Links==		==External Links==

	==References==		==References==

Rossdonaldson1: /* References */

2026-02-04T18:14:06Z

References

← Older revision		Revision as of 18:14, 4 February 2026
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	*[[Conjunctivitis]]		*[[Conjunctivitis]]
	{{Eye algorithms}}		{{Eye algorithms}}

			=+External Links==

	==References==		==References==

Rossdonaldson1 at 19:46, 30 July 2025

2025-07-30T19:46:16Z

← Older revision		Revision as of 19:46, 30 July 2025
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	''This page is for neonatal patients; for non-neonatal pediatric see [[conjunctivitis (peds)]] and adult patients see [[conjunctivitis]]''		''This page is for neonatal patients; for non-neonatal pediatric see [[conjunctivitis (peds)]] and adult patients see [[conjunctivitis]].''
	==Background==		==Background==
	*Neonatal conjunctivitis = ophthalmia neonatorum		*Neonatal conjunctivitis = ophthalmia neonatorum
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	*Occurs on 1st day of life, resolves within 48 hrs		*Occurs on 1st day of life, resolves within 48 hrs
	*Less common now with [[erythromycin]] ointment replacing [[silver nitrate]]		*Less common now with [[erythromycin]] ointment replacing [[silver nitrate]]

	====[[Gonococcal]]====		====[[Gonococcal]]====
	*Presents at 2-7 days of life (peak 3-5)		*Presents at 2-7 days of life (peak 3-5)
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	====[[Chlamydia]]====		====[[Chlamydia]]====
	*Similar exam to gonoccocal but starts at 7-14 days of age		*Similar exam to gonoccocal but starts at 7-14 days of age
	*Peaks from ~~1wk~~ to 1 month after birth		*Peaks from 1 week to 1 month after birth
	*Leading cause of preventable blindness in the world		*Leading cause of preventable blindness in the world
	**Chlamydia conjunctivitis is more common than gonococcal		**Chlamydia conjunctivitis is more common than gonococcal
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	==Disposition==		==Disposition==
	*Gonococcal		*Gonococcal
	**Admit all infants for evaluation of disseminated disease (BCx, UA/UCx, CSF) and ophthalmology consult given high risk		**Admit all infants for evaluation of disseminated disease ([[BCx]], [[UA]]/[[UCx]], [[CSF]]) and ophthalmology consult given high risk
	*Herpetic		*Herpetic
	**Admit		**Admit

Rossdonaldson1 at 19:45, 30 July 2025

2025-07-30T19:45:27Z

← Older revision		Revision as of 19:45, 30 July 2025
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	*Neonatal conjunctivitis = ophthalmia neonatorum		*Neonatal conjunctivitis = ophthalmia neonatorum
	*First 30 days of life		*First 30 days of life
	*Chemical, Gonococcal, Chlamydial, other bacterial, and viral		*Chemical, [[Gonococcal]], [[Chlamydial]], other bacterial, and viral
	*Bacterial causes typically are transmitted during vaginal delivery process (vertical transmission)		*Bacterial causes typically are transmitted during vaginal delivery process (vertical transmission)
	**Per USPSTF, Topical erythromycin for the neonate at birth is recommended as prevention for gonococcal conjunctivitis		**Per USPSTF, Topical erythromycin for the neonate at birth is recommended as prevention for gonococcal conjunctivitis
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	==Evaluation==		==Evaluation==
	*Obtain information about maternal infectious diseases screening during pregnancy		*Obtain information about maternal infectious diseases screening during pregnancy
	*Gram stain/culture to rule out N. gonorrhea vs C. trachomatis		*Gram stain/culture to rule out [[N. gonorrhea]] and [[C. trachomatis]]
	**Gram stain followed by culture is important for gonorrhea		**Gram stain followed by culture is important for gonorrhea
	**Chlamydia is obligate intracellular, so a direct swab and PCR of scleral or palpebral conjunctivitis is needed		**Chlamydia is obligate intracellular, so a direct swab and PCR of scleral or palpebral conjunctivitis is needed
	**If chlamydia is detected, should prompt evaluation for possible gonorrhea co-infection		**If chlamydia is detected, should prompt evaluation for possible gonorrhea co-infection
	*If HSV is suspected, send vesicular fluid for PCR +/- viral culture		*If [[HSV]] is suspected, send vesicular fluid for PCR +/- viral culture

	==Management==		==Management==
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	NB:		NB:
	*For conjunctivitis starting >2 weeks of age, most likely pathogens include S. aureus, S. epi, E. coli, pseudomonas, and non-typable H. Flu.		*For conjunctivitis starting >2 weeks of age, most likely pathogens include [[S. aureus]], [[S. epi]], [[E. coli]], [[pseudomonas]], and non-typable [[H. Flu]].
	*No systemic therapy necessary, treat w/ bacitracin-polymyxin ointment		*No systemic therapy necessary, treat w/ bacitracin-polymyxin ointment

Patricklin at 14:16, 23 July 2025

2025-07-23T14:16:51Z

← Older revision		Revision as of 14:16, 23 July 2025
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	*First 30 days of life		*First 30 days of life
	*Chemical, Gonococcal, Chlamydial, other bacterial, and viral		*Chemical, Gonococcal, Chlamydial, other bacterial, and viral
			*Bacterial causes typically are transmitted during vaginal delivery process (vertical transmission)
			**Per USPSTF, Topical erythromycin for the neonate at birth is recommended as prevention for gonococcal conjunctivitis

	===Types===		===Types===
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	*Occurs on 1st day of life, resolves within 48 hrs		*Occurs on 1st day of life, resolves within 48 hrs
	*Less common now with [[erythromycin]] ointment replacing [[silver nitrate]]		*Less common now with [[erythromycin]] ointment replacing [[silver nitrate]]

	====[[Gonococcal]]====		====[[Gonococcal]]====
	*Presents at 2-7 days of life (peak 3-5)		*Presents at 2-7 days of life (peak 3-5)
	*Bilateral conjunctival erythema, chemosis		*Bilateral conjunctival erythema, chemosis, and eyelid edema
	*Copious purulent discharge		*Copious purulent discharge
	*Has potential to cause loss of vision		*Has potential to cause loss of vision due to corneal ulceration
			**If untreated, may lead to meningitis and bacteremia

	====[[Chlamydia]]====		====[[Chlamydia]]====
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	*Peaks from 1wk to 1 month after birth		*Peaks from 1wk to 1 month after birth
	*Leading cause of preventable blindness in the world		*Leading cause of preventable blindness in the world
			**Chlamydia conjunctivitis is more common than gonococcal
	*May present with otitis and chlamydial pneumonia with staccato cough		*May present with otitis and chlamydial pneumonia with staccato cough

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	*Peaks at 6-14 days of life		*Peaks at 6-14 days of life
	*Presents with inflammation and edema, less likely purulence		*Presents with inflammation and edema, less likely purulence
	*Look for other mucocutaneous lesions and assess mother for herpes		*Look for other mucocutaneous vesicular lesions and assess mother for herpes
	*May lead to keratitis and disseminated infection		*May lead to keratitis and disseminated infection
	*Vesicles + conjunctivitis = acyclovir + full sepsis w/u, including for disseminated herpes		*Vesicles + conjunctivitis = acyclovir + full sepsis w/u, including for disseminated herpes
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	==Evaluation==		==Evaluation==
			*Obtain information about maternal infectious diseases screening during pregnancy
	*Gram stain/culture to rule out N. gonorrhea vs C. trachomatis		*Gram stain/culture to rule out N. gonorrhea vs C. trachomatis
	**~~C. trachomatis will have negative gram~~ stain ~~because it~~ is an intracellular ~~parasite.~~		**Gram stain followed by culture is important for gonorrhea
			**Chlamydia is obligate intracellular, so a direct swab and PCR of scleral or palpebral conjunctivitis is needed
			**If chlamydia is detected, should prompt evaluation for possible gonorrhea co-infection
			*If HSV is suspected, send vesicular fluid for PCR +/- viral culture

	==Management==		==Management==

ClaireLewis: /* References */

2019-10-05T17:14:22Z

References

← Older revision		Revision as of 17:14, 5 October 2019
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	[[Category:Pediatrics]]		[[Category:Pediatrics]]
	[[Category:Ophthalmology]]		[[Category:Ophthalmology]]
			[[Category:ID]]

Rossdonaldson1: /* Disposition */

2019-07-20T11:22:14Z

Disposition

← Older revision		Revision as of 11:22, 20 July 2019
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	==Disposition==		==Disposition==
	*Gonococcal		*Gonococcal
	**Admit		**Admit all infants for evaluation of disseminated disease (BCx, UA/UCx, CSF) and ophthalmology consult given high risk
	*Herpetic		*Herpetic
	**Admit		**Admit

Gheid: /* Herpetic */

2019-06-20T21:08:22Z

Herpetic

← Older revision		Revision as of 21:08, 20 June 2019
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	====[[Herpes\|Herpetic]]====		====[[Herpes\|Herpetic]]====
	*Peaks at 6-14 days of life		*Peaks at 6-14 days of life
			*Presents with inflammation and edema, less likely purulence
			*Look for other mucocutaneous lesions and assess mother for herpes
	*May lead to keratitis and disseminated infection		*May lead to keratitis and disseminated infection
	*Vesicles + conjunctivitis = acyclovir + full sepsis w/u, including for disseminated herpes		*Vesicles + conjunctivitis = acyclovir + full sepsis w/u, including for disseminated herpes

Gheid: /* Management */

2019-06-20T21:05:56Z

Management

← Older revision		Revision as of 21:05, 20 June 2019
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	{{Neonatal conjunctivitis treatment}}		{{Neonatal conjunctivitis treatment}}

	~~Note~~:
			NB:
	*For conjunctivitis starting >2 weeks of age, most likely pathogens include S. aureus, S. epi, E. coli, pseudomonas, and non-typable H. Flu.		*For conjunctivitis starting >2 weeks of age, most likely pathogens include S. aureus, S. epi, E. coli, pseudomonas, and non-typable H. Flu.
	*No systemic therapy necessary, treat w/ bacitracin-polymyxin ointment		*No systemic therapy necessary, treat w/ bacitracin-polymyxin ointment

Gheid: /* Management */

2019-06-20T21:05:06Z

Management

← Older revision		Revision as of 21:05, 20 June 2019
Line 47:		Line 47:
	==Management==		==Management==
	{{Neonatal conjunctivitis treatment}}		{{Neonatal conjunctivitis treatment}}

			Note:
			*For conjunctivitis starting >2 weeks of age, most likely pathogens include S. aureus, S. epi, E. coli, pseudomonas, and non-typable H. Flu.
			*No systemic therapy necessary, treat w/ bacitracin-polymyxin ointment

	==Disposition==		==Disposition==