Conjunctivitis (peds): Difference between revisions
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Neonatal Conjunctivitis | Neonatal Conjunctivitis | ||
==Background== | ==Background== | ||
*Vesicles + conjunctivitis = full sepsis eval + acyclovir | *Vesicles + conjunctivitis = full sepsis eval + acyclovir | ||
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*Chlamydia | *Chlamydia | ||
**Peaks from 1wk to 1 month after birth | **Peaks from 1wk to 1 month after birth | ||
*Herpetic | |||
**Peaks at 6-14 days of life | |||
**May lead to keratitis and disseminated infection | |||
==Treatment== | ==Treatment== | ||
| Line 31: | Line 33: | ||
**Erythromycin 50mg/kg PO QD in 4 divided doses x 14 days | **Erythromycin 50mg/kg PO QD in 4 divided doses x 14 days | ||
**Topical tx is unnecessary | **Topical tx is unnecessary | ||
*Herpetic | |||
**Acyclovir 20mg/kg IV q8hr x 14-21d | |||
**Topical antiviral | |||
**Full sepsis evaluation | |||
*Chemical | *Chemical | ||
**Watchful waiting | **Watchful waiting | ||
| Line 36: | Line 42: | ||
==Disposition== | ==Disposition== | ||
*Gonococcal | *Gonococcal | ||
**Admit | |||
*Herpetic | |||
**Admit | **Admit | ||
Revision as of 19:27, 14 June 2011
Neonatal Conjunctivitis
Background
- Vesicles + conjunctivitis = full sepsis eval + acyclovir
Diagnosis
- Chlamydial
- Can range from mild to severe hyperemia w/ thick mucopurulent discharge
- Gonococcal
- May present as typical conjunctivitis or w/ severe lid edema, cornea ulceration
Work-Up
- Gram stain/culture to r/o gonorrhea
DDx
- Chemical
- Due to ocular prophylaxis
- Occurs on 1st day of life
- Gonococcal
- Peaks at 3-5 days after birth
- Has potential to cause loss of vision
- Chlamydia
- Peaks from 1wk to 1 month after birth
- Herpetic
- Peaks at 6-14 days of life
- May lead to keratitis and disseminated infection
Treatment
- Gonococcal
- Cefotaxime 100mg/kg IV or IM OR CTX 25-50mg/kg IV or IM x1 (not to exceed 125mg)
- Cefotaxime is preferred b/c does not displace bilirubin
- Disseminated disease should be suspected until CSF is negative
- Topical tx is unnecessary
- Cefotaxime 100mg/kg IV or IM OR CTX 25-50mg/kg IV or IM x1 (not to exceed 125mg)
- Chlamydial
- Erythromycin 50mg/kg PO QD in 4 divided doses x 14 days
- Topical tx is unnecessary
- Herpetic
- Acyclovir 20mg/kg IV q8hr x 14-21d
- Topical antiviral
- Full sepsis evaluation
- Chemical
- Watchful waiting
Disposition
- Gonococcal
- Admit
- Herpetic
- Admit
Source
Tintinalli