Ophthalmia neonatorum within first 48 hours of birth is caused by
Ans. b (Neisseria gonorrheae) (Ref: Parson's, 18th ed/140)DIFFERENTIAL DIAGNOSIS OF NEONATAL CONJUNCTIVITIS (OPHTHALMIA NEONATORUM)CauseOnsetFindingsCytology&lab tests(1)Toxic AgNO3- Silver nitrate (Crede's prophylaxis)Within hoursHyperemiaSlight watery to mucoid discharge. Negative culture(2)Gonococci (gonococcal conjunctivitis)2nd-4th day of lifeAcute purulent conjunctivitisIntracellular gram-negative diplococci.Positive culture on blood and chocolate agar(3)Other bacteria (Pseudomonas aeruginosa, Staphylococcus aureus, Streptococcus pneumoniae; Haemophilus)4th-5th day of lifeMucopurulent conjunctivitisCulture on bloodagar(4)Chlamydia (inclusion conjunctMtis)... most common5th-14th day of lifeMucopurulent conjunctivitisGiemsa-positive cytoplasmic inclusion bodies in epithelial cells.Negative culture.(5)Herpes simplex virus5th-7th day of lifeWatery blepharoconjunctivitis. Corneal involvement.Systemic manifestations.Multinucleated gaint cells, cytoplasmic inclusion bodies.Negative cultureEducational Points:Intact corneal epithelium cannot be penetrated b\ any organism EXCEPT-# Neisseria gonorrhoeae# Neisseria meningitides# Cornybacterium diphtheriaeConjunctivitis FeaturesAcute mucopurulent conjunctivitis# Staph, is commonest causative organism.Ophthalmia neonatorum# Chlamydia is most common causative organism (7-10 days)# Presents at birth/in a hour of birth (Chemical)# Treatment is Credes prophylaxis with 1% silver nitrateLigneous conjunctivitis# Membranous but repeated conjunctivitisAngular conjunctivitis# Caused by Moraxella. Treatment is zinc oxideFollicular conjunctivitis# Trachoma, drug induced,New Castle's conjunctivitis# Epidemic keratoconjunctivitis sicca (adenovirus)Acute herpetic conjunctivitis# occurs in young children infected from contagion of carrierVernal conjunctivitis (Spring catarrh)# Bulbar and palpebral conjunctivitis# Bilateral and recurrent# Ropy discharge# 'Cobble stone' palpebral conjunctiva# Gaint papilla # Horner-Trantas spots# Maxwell-Lion sign# Pseudogerontoxon# Treatment with steroids, acetyl cysteine and topical NSAIDEducational point:# Sulphacetamide eye drops used for ophthalmia neonatorum.
Adenovirus
Neiserria gonorhoeae
Candida albicans
Chlamydia trachomatis
Conjuctiva