Conjunctivitis in newborns

Chlamydial conjunctivitis

Chlamydia trachomatis is the most common causative agent of neonatal conjunctivitis in the West. The disease occurs as a one-way process, but quickly spreads to the second eye. Characterized by watery edema of the eyelids with a moderate amount of mucous or mucoid-purulent discharge. It is often combined with pneumonia. Treatment includes a course of erythromycin in the form of a syrup at a daily dose of 40 mg / kg of weight, for 14 days. At the same time, parents are treated. Oral administration of medications is more effective than their local application.

[1], [2], [3], [4]

Gonococcal conjunctivitis

Occurs in the first days of a child's life and quickly passes into a severe purulent form. The cornea is often affected. Treatment includes the appointment of penicillin drugs (benzyl-penicillin at a daily dose of 30 mg / kg of weight 2-3 times a day); in the isolation of penicillinase-producing Neisseria gonorrhoeae, cephalosporins, for example, cefuroxin, are administered at a daily dose of 100 mg / kg of body weight 3 times a day for 7 days. Treatment is complemented by topical application of such antibiotics as 1% erythromycin solution and 1% gentamicin solution. Recommend frequent irrigation of the eyeball with warm physiological solution.

Other microorganisms that cause 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 canal:
   • 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, eyelid edema and mucopurulent discharge.
4. Spring conjunctivitis in combination with keratitis and giant papillae of the eyelid conjunctiva.
5. The disease of cat scratch.
6. Syndrome of "dry" eyes.
7. Foreign bodies.

Viral conjunctivitis

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

Study

The primary role is played by clinical examination. It is necessary to exclude the obstruction of the nasolacrimal canal. The diagnosis can be established on the basis of anamnesis and discharge of mucopurulent discharge when pressed onto the tear sack. The material for isolating gram-negative diplococcus and other bacterial flora is scrapings from the conjunctiva. With the help of McCoy cell culture or PCR reaction, chlamydia is excluded. Gypsum staining (Giemsa) helps to detect cytoplasmic inclusions of chlamydia. To isolate other microorganisms, an appropriate serological and bacteriological study is carried out.

Prevention

1% solution of silver nitrate with a preventive purpose is currently used rarely. Common tactics do not exist, but they carry out the following activities:

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