Neonatal Problems: Neonatal Conjunctivitis

Description

Neonatal conjunctivitis, also known as conjunctivitis of the newborn , newborn conjunctivitis and ophthalmia neonatorum , is an eye infection of the newborn acquired during the passage through the birth canal. The most common birth-related bacterial infections with the potential to cause eye damage are gonorrhoea (Neisseria gonorrhoea) and Chlamydia (Chlamydia trachomatis) as well as the herpes virus , however the incidence of herpes conjunctivitis is less than the others. Streptococcus pneumoniae and Hemophilus influenzae may also cause neonatal conjunctivitis.
These infections are usually picked up by the mother-to-be as a STD . Chlamydia may be the most common STD in the United States today (however, gonorrhoea is the most common reported bacterial infection) and Chlamydial conjunctivitis in the newborn is seen 10 times as frequently as gonorrhoeal conjunctivitis.

Because of the significance of neonatal conjunctivitis, all hospitals routinely use silver nitrate or antibiotic drops in the newborn's eyes to prevent disease. Silver nitrate is no longer commonly used and has been mostly replaced by antibiotic eye drops.

Symptoms and Signs

The mother may be asymptomatic (without symptoms) at the time of delivery yet still harbour bacteria or a virus capable of causing conjunctivitis in her newborn infant. Symptoms and Signs in the infant include:

• Watery, bloody ( serosanguineous ) drainage from the infant's eyes. Usually within 1 day to 2 weeks after birth.
• Thick pus-like ( purulent ) drainage from the infant's eyes.
• Swollen, red eyelids.
• Tensely swollen eyelids.
• Gonorrhoea may cause perforation of the cornea and very significant destruction of the deeper eye structures. Chlamydia is somewhat less destructive.

Diagnosis and Treatment

The main diagnostic techniques used include a standard ophthalmologic examination ; a slit lamp examination to look for corneal ulceration, perforation, or other changes (called iridocyclitis and inclusion blennorrhea) and a culture of the drainage from the eye to look for N. gonorrhoea and C. trachomatis.
Treatment options, usage of which depends on the severity of the infection and the organism involved, include:

• Topical antibiotic eye drops and ointments
• Oral antibiotics
• IV antibiotics.
• Irrigation of the eye with normal saline (same amount of salt dissolved in the water as is in blood) is performed to remove the purulent drainage that accumulates.

Infants who develop conjunctivitis and are quickly treated generally have good outcomes.

See also the page on conjunctivitis in children .

The information in this page is presented in summarised form and has been taken from the following source(s):
1. Medline Plus Medical Encyclopaedia, U.S. National Library of Medicine: http://medlineplus.gov