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Ophthalmia%20neonatorum Signs and Symptoms
Introduction
- Also called neonatal conjunctivitis
- One of the leading cause of blindness in infants via corneal ulceration & subsequent opacification or perforation & endophthalmitis
- Pneumonia & otitis media are reported in some of the newborn w/ Chlamydia conjunctivitis
Definition
- Conjunctivitis occuring in a newborn during the first month of life
Etiology
- Organisms causing neonatal conjunctivitis are usually acquired from the infected birth canal of the mother during vaginal delivery, though some may acquire the infection from their immediate surroundings
- Bacteria may be transmitted to the infant after birth through air w/ association w/ obstructed nasolacrimal duct
- Gram positive organisms:
- Staphylococcus aureus
- Streptococcus viridians
- Streptococcus pneumoniae
- Staphylococcus epidermidis
- Gram negative organisms:
- Escherichia coli
- Haemophilus sp.
- Enterobacter sp.
- Klebsiella pneumonia
- Proteus sp.
- Serratia marcescens
- Pseudomonas sp., rarely occur but may cause corneal perforation, blindness & death
- Time of onset: 2-5 days postpartum
- Clinical presentation:
- Eyelid edema
- Conjunctival injection w/ discharge
- Chemosis
- Milder course w/o corneal & systemic involvement
- Herpes simplex (HSV) virus type 2 can rarely cause neonatal conjunctivitis
- Time of onset: 3-15 days postpartum
- Clinical presentation:
- Vesicular skin lesions of the lid or lid margin
- Non-specific lid edema
- Moderate conjunctival injection
- Non-purulent serosanguinous discharge
- True conjunctival membranes
- Corneal geographic or micro-dendritic epithelial keratitis different from the typical adult herpetic dendrites
Signs and Symptoms
- Eyelid & palpebral conjunctiva erythema & edema
- Purulent eye discharge
Risk Factors
- Inadequate or no prenatal care
- Maternal infections (especially sexually transmitted diseases) before & during pregnancy
- Exposure of the infant to infectious organisms
- Inadequacy of ocular prophylaxis immediately after birth
- Organisms harboring in the mother’s birth canal
- Increased shedding of organisms in the vaginal tract of the mother during the last trimester
- Ocular trauma during delivery
- Premature rupture of membranes
- Prolonged labor
