Ophthalmia neonatorum is also referred to as neonatal conjunctivitis and is associated with an acute, mucopurulent inflammation of ocular tissues of neonates. It typically affects newborns within their first month of life.
In cases of infectious ON, incubation periods vary with the causative agent. Neonates may acquire Chlamydia trachomatis or Neisseria gonorrhoeae from their infected mothers during birth, and symptom onset typically occurs 5 to 14 days or 2 to 5 days afterwards, respectively . Other infectious diseases may be contracted later on and may thus manifest in newborns aged two weeks and older. Initially, catarrhal conjunctivitis may be observed. Ocular discharge may turn mucopurulent within a few days, and additional signs like chemosis, eyelid edema, blepharitis, and keratitis may be noted. In severe cases, corneal ulcers may form and lead to blindness. The presence of respiratory symptoms may indicate the concomitant involvement of respiratory system. Affected neonates commonly present feeding difficulties.
ON due to the instillation of silver nitrate generally manifests within two days.
Entire Body System
RESULTS: Each of the eight included studies had substantial methodologic weaknesses. Data to estimate the efficacy of prophylaxis in the prevention of gonococcal ophthalmia neonatorum (GON) were not available. [ncbi.nlm.nih.gov]
Rhinoscleroma, Klebsiella pneumonia Klebsiella granulomatis Granuloma inguinale Klebsiella oxytoca Escherichia coli : Enterotoxigenic Enteroinvasive Enterohemorrhagic O157:H7 O104:H4 Hemolytic-uremic syndrome Enterobacter aerogenes / Enterobacter cloacae Slow/weak [en.wikipedia.org]
Affected neonates commonly present feeding difficulties. ON due to the instillation of silver nitrate generally manifests within two days. As it has been indicated above, distinct pathogens may account for infectious ON. [symptoma.com]
The laboratory technicians had no knowledge of which prophylactic ocular medication dose was given to any infant. [bjo.bmj.com]
Control neonates had either neonatal jaundice or mild respiratory distress but no signs of conjunctivitis. 2 controls matched for age and sex were chosen for each neonate with conjunctivitis. [ncbi.nlm.nih.gov]
Other neonatal risk factors (51%) included sepsis, jaundice, and respiratory distress [Table 3]. [meajo.org]
RESULTS: Of the neonates receiving the one eye drop application, 18.4% returned with a red eye with discharge, 4.0% had organisms found on the initial smear, and 8.2% had a positive culture. [ncbi.nlm.nih.gov]
Diagnostic Considerations Exclude other potential causes of acute red eye, such as preseptal cellulitis or orbital cellulitis. Congenital dacryostenosis is another condition to consider in the differential diagnosis of neonatal conjunctivitis. [emedicine.medscape.com]
Results: Of the neonates receiving the one eye drop application, 18.4% returned with a red eye with discharge, 4.0% had organisms found on the initial smear, and 8.2% had a positive culture. [bjo.bmj.com]
Depending on the pathogen, there may be a mixed picture of a red eye with lid swelling and a varying amount of purulent discharge. [patient.info]
Characterized by lacrimation, blepharospasm, keratitis and corneal opacity. ophthalmia neonatorum a purulent conjunctivitis occurring during the first 10 days of life, before the eyelids separate in puppies and kittens. [medical-dictionary.thefreedictionary.com]
As it has been indicated above, distinct pathogens may account for infectious ON. It is of major importance to identify the causative pathogen in individual cases. Infections with Chlamydia trachomatis or Neisseria gonorrhoeae may cause systemic disease and life-threatening complications like pneumonia and sepsis. Although less frequently reported, complications may also arise from infections with other pathogens . It is important to note that the determination of the etiological agent and its susceptibility to antimicrobials is of significant therapeutic relevance .
In order to prove the presence of bacterial pathogens, conjunctival swabs should be taken and samples should be prepared for Gram staining , bacterial culture, and molecular biological assays. Of note, Chlamydia trachomatis is an obligate intracellular microorganism and thus can not be grown on conventional media . It is best detected by means of polymerase chain reaction. In contrast, Neisseria gonorrhoeae may be grown on Thayer-Martin or Martin-Lewis agar. Nevertheless, nucleic acid amplification tests may also be carried out to detect this pathogen and are increasingly replacing conventional methods.
Molecular biological assays are also indicated to prove the presence of viral pathogens.
ON may indicate an infection with either of the following bacterial pathogens :
- Chlamydia trachomatis
- Neisseria gonorrhoeae
- Staphylococcus aureus
- Staphylococcus epidermidis
- Streptococcus pneumoniae
- Streptococcus viridans
- Enterobacter spp.
- Escherichia coli
- Klebsiella pneumoniae
- Proteus spp.
- Serratia marcescens
- Haemophilus influenzae
- Pseudomonas aeruginosa
Silver nitrate has been used to prevent neonatal conjunctivitis induced by Neisseria gonorrhoeae. However, this measure may provoke non-infectious, chemical conjunctivitis.
Ophthalmia neonatorum (ON), a condition also referred to as neonatal conjunctivitis, is defined as an inflammation of the mucous membranes of the eye of newborns during their first month of life. ON may be a result of bacterial or viral infection, or may be caused by the instillation of chemical agents. While many cases resolve spontaneously within a few days, severe complications may occur . In fact, ON may result in blindness  . Fortunately, ON-associated morbidity has decreased significantly since antimicrobial medications have become widely available.
Newborns may contract the respective infections during vaginal delivery or postnatally from colonized family members or healthcare professionals; chemical ON is related to the prophylaxis of infectious ON. Nevertheless, prophylactic measures are indicated in neonates born to mothers suffering from chlamydia infection or gonorrhea, and in all newborns in underdeveloped regions with high prevalence rates of these sexually transmissible diseases. No consensus has been reached regarding the application of prophylactic measures in neonates born to apparently healthy mothers in developed countries  .
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