Conjunctivitis in Newborns

Aka: Conjunctivitis in Newborns, Neonatal Conjunctivitis, Ophthalmia Neonatorum, Eye Discharge in Newborns

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II. Definition

  1. Conjunctivitis within the first 4 weeks of life

III. Pathophysiology

  1. Typically vertical transmission via birth canal

IV. Causes

  1. Chemical Conjunctivitis (most common)
    1. Typically a reaction to prophylactic Topical Antibiotics applied at birth (less common with Erythromycin than Silver Nitrate)
    2. Mild palpebral edema and clear, sterile Eye Discharge
    3. Onset <24-36 hours within eye prophylaxis at birth
    4. Resolves within 48 hours of birth
  2. Gonorrheal Conjunctivitis
    1. See Gonorrhea
    2. Onset typically within 2-4 days of life (up to 7 days of life)
    3. Severe bilateral involvement with lid edema, Chemosis, and purulent exudates
    4. Risk of Corneal Ulcer and Corneal perforation
  3. Chlamydia Conjunctivitis
    1. Onset within 5-14 days of birth (up to 3-4 weeks)
    2. Initial mild watery discharge
    3. Progresses to diffuse swelling and Chemosis with copious and purulent discharge
  4. Herpes Simplex Virus Conjunctivitis (HSV Conjunctivitis)
    1. Onset within 6-14 days of birth
    2. Up to 20% of HSV infected infants are affected
    3. Corneal Herpetic Dendrites on Fluorescein stain
    4. Risk of disseminated Herpes Simplex Virus
    5. Risk of Vision Loss as well as Keratitis, Uveitis, Cataracts, chorioretinitis, Optic Neuritis
  5. Other causes
    1. Moraxella catarrhalisConjunctivitis
    2. Adenovirus

V. Differenital Diagnosis

  1. Dacryostenosis (blocked tear ducts)
    1. Common in infants, presenting with a build-up of yellow, sticky, non-purulent secretions
    2. Treated with warm compresses to the eye

VI. Prevention

  1. Erythromycin ophthalmic ointment in first hour of life

VII. References

  1. Williams (2017) Crit Dec Emerg Med 31(2): 3-12
  2. Yanoff (1999) Ophthalmology, Mosby, p. 1.7
  3. Fuloria (2002) Am Fam Physician 65(1):61-8 [PubMed]

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Related Studies

Ontology: Conjunctivitis (C0009763)

Definition (NCI) Inflammation of the conjunctiva of the eye.
Definition (NCI_CTCAE) A disorder characterized by inflammation, swelling and redness to the conjunctiva of the eye.
Definition (NCI_NCI-GLOSS) A condition in which the conjunctiva (membranes lining the eyelids and covering the white part of the eye) become inflamed or infected.
Definition (CSP) inflammation of the mucous membrane that lines the inner surface of the eyelids and the anterior part of the sclera; also called pinkeye and redeye.
Concepts Disease or Syndrome (T047)
MSH D003231
ICD9 372.30
ICD10 H10 , H10.9
SnomedCT 193857008, 193875009, 193858003, 9826008
LNC MTHU020828
English Conjunctivitides, Conjunctivitis, Conjunctivitis, unspecified, conjunctivitis, conjunctivitis (diagnosis), Unspecified conjunctivitis, Conjunctivitis [Disease/Finding], inflammation of conjunctiva, conjunctiva inflammation, Conjunctivitis NOS, Unspecified conjunctivitis (disorder), Conjunctiva inflamed, CONJUNCTIVITIS, Pink Eye, Inflammation of conjunctiva, Conjunctivitis (disorder), Conjunctivitis, NOS
French CONJONCTIVITE, Conjonctivite, non précisée, Conjonctivite SAI, Conjonctivite
Portuguese CONJUNTIVITE, Conjuntivite NE, Conjuntivite
Spanish CONJUNTIVITIS, Conjuntivitis NEOM, Conjuntivitis no especificada, conjuntivitis no especificada (trastorno), conjuntivitis no especificada, conjuntivitis (trastorno), conjuntivitis, inflamación de la conjuntiva, Conjuntivitis
German KONJUNKTIVITIS, Konjunktivitis NNB, Konjunktivitis, unspezifisch, Konjunktivitis, nicht naeher bezeichnet, Konjunktivits, Konjunktivitis, Augenbindehaut-Entzündung, Bindehautentzündung
Dutch conjunctivitis, niet-gespecificeerd, conjunctivitis NAO, Conjunctivitis, niet gespecificeerd, conjunctivitis, Conjunctivitis
Italian Congiuntivite NAS, Congiuntivite, non specificata, Congiuntivite
Japanese 結膜炎ＮＯＳ, 結膜炎, 結膜炎、詳細不明, ｹﾂﾏｸｴﾝｼｮｳｻｲﾌﾒｲ, ｹﾂﾏｸｴﾝ, ｹﾂﾏｸｴﾝNOS
Swedish Bindhinneinflammation
Czech konjunktivitida, spojivka - zánět, zánět spojivek, Konjunktivitida, Konjunktivitida NOS, Blíže neurčená konjunktivitida
Finnish Sidekalvotulehdus
Russian KON"IUNKTIVIT, КОНЪЮНКТИВИТ
Korean 결막염, 상세불명의 결막염
Croatian KONJUNKTIVITIS
Polish Zapalenie spojówek
Hungarian Kötőhártyagyulladás, Conjunctivitis k.m.n., Kötőhártyagyulladás, nem meghatározott
Norwegian Øyebetennelse, Konjunktivitt, Øyekatarr, Bindehinnebetennelse
Derived from the NIH UMLS (Unified Medical Language System)

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