Neonatal conjunctivitis: Difference between revisions
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==Clinical Features== | ==Clinical Features== | ||
===[[Chlamydia]]=== | |||
*Can range from mild to severe hyperemia w/ thick mucopurulent discharge | |||
===[[Gonococcal]]=== | |||
*May present as typical conjunctivitis or w/ severe lid edema, cornea ulceration | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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==Treatment== | ==Treatment== | ||
===[[Gonococcal]]=== | |||
*Cefotaxime 100mg/kg IV or IM OR [[ceftriaxone]] 25-50mg/kg IV or IM x1 (not to exceed 125mg) | |||
**Cefotaxime is preferred because it does not displace bilirubin | |||
**Disseminated disease should be suspected until CSF is negative | **Disseminated disease should be suspected until CSF is negative | ||
**Topical | **Topical treatment is unnecessary | ||
===[[Chlamydia]]=== | |||
*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== | ==Disposition== | ||
Revision as of 20:01, 20 May 2015
Background
- Vesicles + conjunctivitis = full sepsis eval + acyclovir
Clinical Features
Chlamydia
- Can range from mild to severe hyperemia w/ thick mucopurulent discharge
Gonococcal
- May present as typical conjunctivitis or w/ severe lid edema, cornea ulceration
Differential Diagnosis
- 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
- Leading cause of preventable blindness in the world
- Herpetic
- Peaks at 6-14 days of life
- May lead to keratitis and disseminated infection
Diagnosis
- Gram stain/culture to r/o N. gonorrhea vs C. trachomatis
- C. trachomatis will have negative gram stain because it is an intracellular parasite.
Treatment
Gonococcal
- Cefotaxime 100mg/kg IV or IM OR ceftriaxone 25-50mg/kg IV or IM x1 (not to exceed 125mg)
- Cefotaxime is preferred because it does not displace bilirubin
- Disseminated disease should be suspected until CSF is negative
- Topical treatment is unnecessary
Chlamydia
- 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
See Also
Source
Tintinalli