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Suspected Neonatal Conjunctivitis

Neonatal conjuntivitis, also known as opthalmia neonatorium, should be suspected clinically among neonates (≤28 days of age) with both injected conjunctiva and mucopurulent discharge, or among those infants with hemorrhagic ocular discharge. Neonatal conjunctivitis can be due to both infectious and non-infectious etiologies. The 2015 Red Book estimates that the major infectious pathogens associated with neonatal conjuntivitis include 'other bacterial microbes' (30 to 50%) and Chlamydia trachomatis (2 to 40%). Less fequently identified pathogens include Neisseria Gonorrhea (less than 1%) and Herpes simplex virus (less than 1%). Cases of neonatal conjuntivitis secondary to Chlamydia trachomatis and Neisseria Gonorrhea have the potential for the most significant clinical outcomes and still account for the leading cause of blindness worldwide. Newborn risk and incidence of C. trachomatis and N. gonorrhea are affected by the prevalence of maternal infections.

References:

Committe on Infectious Diseases. (2015). Red Book: Report of the Commitee on Infectious Diseases (2015)(Kimberlin DW, Brady, MT, Jackson MA, & Long, SSEds. 30 ed.).

Workowski, K.A., Bolan, G.A., Centers for Disease Control and Prevention. (2015). Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep, 64(RR-03), 1-137.

These guidelines do not establish a standard of care to be followed in every case. It is recognized that each case is different and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare guidelines for each. Accordingly these guidelines should guide care with the understanding that departures from them may be required at times.