bubble_chart Overview

The pathogens of neonatal conjunctivitis are commonly Chlamydia and cocci. Conjunctivitis caused by different pathogens has distinct characteristics.

1. Chlamydial conjunctivitis

   Chlamydia is a microorganism that inhabits cells in Chinese Taxillus Herb. It can cause conjunctivitis and pneumonia in infants and young children. Due to its increasing detection rate, it has become one of the important disease causes of neonatal conjunctivitis. The infection often occurs when the father of the infant has chlamydial urethritis, leading to cervicitis in the mother, though parents are usually asymptomatic. Pregnant mothers often have a history of premature rupture of membranes, so the amniotic fluid may already be contaminated, and the fetus can be infected in utero or during passage through the vagina. In reality, clinical cases of neonatal conjunctivitis are not very common. The incubation period is 5–13 days, and the onset is later than bacterial conjunctivitis. Between 5–14 days after birth, conjunctival congestion occurs, accompanied by purulent mucus discharge, which resolves spontaneously over weeks or months without leaving scars or affecting the cornea.

   Prevention involves administering 1% rifampin eye drops three times a day for 2–3 days immediately after birth.

   If a pregnant woman tests positive for vaginal Chlamydia, oral roxithromycin can be taken during the advanced stage of pregnancy. The treatment for the infant's father with chlamydial urethritis is the same as for the pregnant woman. Treatment for infected infants is prolonged, using 1% rifampin or ofloxacin eye drops until symptoms completely disappear.

2. Bacterial conjunctivitis

   In the past, gonococci were the most common bacteria causing bacterial conjunctivitis, but Staphylococcus aureus, Staphylococcus epidermidis, streptococci, and Escherichia coli are also frequently observed. The source of gonococcal infection is the same as for Chlamydia, transmitted from parents, while other bacteria may be transmitted during vaginal delivery. However, most infections result from contaminated hands of caregivers (such as parents or medical staff). The incubation period for bacterial infections is about 12–48 hours, so the onset is earlier, with severe symptoms appearing 2–3 days after birth, including eyelid edema, conjunctival congestion, and purulent discharge. The inflammation may involve the cornea, even leading to ulceration and perforation.

Prevention of gonococcal conjunctivitis can be achieved using Credé's method: (1) Immediately after birth, apply 1% silver nitrate eye drops, followed by rinsing with saline to reduce chemical irritation. (2) To prevent postnatal infectious conjunctivitis, caregivers must wash their hands before handling the infant and avoid using rough or contaminated cloths to clean the infant's eyes. (3) If the infant has excessive eye discharge, rinse the eyes with saline or 3% boric acid solution. Treatment involves antibiotic eye drops based on the bacterial type, such as 1% rifampin or ofloxacin eye drops. (4) For gonococcal conjunctivitis, in addition to topical medication, intramuscular ampicillin should be administered once daily for 7 days.