Suspected Neonatal Conjunctivitis
Neonatal conjunctivitis, also known as ophthalmia neonatorum, 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 conjunctivitis include 'other bacterial microbes' (30 to 50%) and Chlamydia trachomatis (2 to 40%). Less frequently identified pathogens include Neisseria gonorrhoeae (less than 1%) and herpes simplex virus (less than 1%). Cases of neonatal conjunctivitis secondary to Chlamydia trachomatis and Neisseria gonorrhoeae have the potential for the most significant clinical outcomes and still account for the leading cause of blindness worldwide.
References:
Committee on Infectious Diseases. (2015). Red Book: Report of the Committee on Infectious Diseases (2015) (Kimberlin DW, Brady, MT, Jackson MA, & Long, SSEds. 30 ed.).
These pathways 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 a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.