Conjunctivitis in newborns

Chlamydial conjunctivitis

Chlamydia trachomatis is the most common cause of neonatal conjunctivitis in the West. The disease occurs as a unilateral process, but quickly spreads to the second eye. Watery swelling of the eyelids with a moderate amount of mucous or mucopurulent discharge is characteristic. It is often combined with pneumonia. Treatment includes a course of erythromycin in the form of syrup at a daily dose of 40 mg / kg of weight, for 14 days. The parents are treated at the same time. Oral administration of drugs is more effective than their topical use.

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Gonococcal conjunctivitis

It occurs in the first days of a child's life and quickly develops into a severe purulent form. The cornea is often affected. Treatment includes the administration of penicillin drugs (benzyl penicillin at a daily dose of 30 mg / kg of body weight 2-3 times a day); when penicillinase-producing Neisseria gonorrhoeae is isolated, cephalosporins are prescribed, such as cefuroxine, at a daily dose of 100 mg / kg of body weight 3 times a day for 7 days. Treatment is supplemented by local use of antibiotics such as 1% erythromycin solution and 1% gentamicin solution. Frequent irrigation of the eyeball with warm saline solution is recommended.

Other microorganisms causing conjunctivitis: Staphylococcus aureus, Staph. epidermidis, Streptococcus viridans, Strep. pneumoniae, Escherichia coli, Serratia spp., Pseudomonas spp., Haemophilus spp.

Viscous discharge from the conjunctival cavity in children

1. Obstruction of the nasolacrimal duct:
   • in combination with mucocele;
   • in the absence of mucocele (usually accompanied by epiphora).
2. Conjunctivitis:
   • newborns;
   • in older children - bacterial, viral and others.
3. Allergic conjunctivitis with symptoms including itching, swelling of the eyelids and mucopurulent discharge.
4. Spring conjunctivitis combined with keratitis and giant papillae of the conjunctiva of the eyelids.
5. Cat scratch disease.
6. Dry eye syndrome.
7. Foreign bodies.

Viral conjunctivitis

Viral conjunctivitis is often associated with the herpes simplex virus. Sometimes adenovirus infection occurs in the first days of a child's life, and appropriate treatment is prescribed.

Study

Clinical examination plays a primary role. It is necessary to exclude obstruction of the nasolacrimal canal. The diagnosis can be established based on the anamnesis and the release of mucopurulent discharge when pressing on the lacrimal sac. The material for isolating gram-negative diplococci and other bacterial flora are scrapings from the conjunctiva. Using McCoy cell culture or PCR reaction, chlamydia is excluded. Giemsa staining helps to detect cytoplasmic inclusions of chlamydia. To isolate other microorganisms, appropriate serological and bacteriological studies are carried out.

Prevention

1% silver nitrate solution is rarely used for prophylactic purposes at present. There is no generally accepted tactic, but the following measures are taken:

• local application of 0.5% erythromycin ointment;
• local application of 1% tetracycline ointment;
• povidone iodine.