a presentation on conjunctivitis in newborn.ppt

a presentation on conjunctivitis in newborn.ppt

1. OPHTHALMIA NEONATORUM

2. OPHTHALMIA NEONATORUM
Ophthalmia neonatorum, also
called
 neonatal conjunctivitis, is an
acute, mucopurulent infection occurring
in the first 4 weeks of life.
It is rare and acute.
The infection is acquired from the
mother during delivery.
It must be treated immediately to
prevent permanent eye damage or
blindness.

3. OPHTHALMIA NEONATORUM
Neonatal conjunctivitis is swelling (inflammation) or infection
of the tissue lining the eyelids in a newborn.
Causes
There are types.
1. Infectious
2. Non-infectious
Infectious: caused by bacterial infections such as N.
gonorrhoeae, C.trachomatis (most common causes) present in
the birth canal of an infected woman. • Also caused by
S.aureus, Strep pneumonia, Pseudomona spp.,Haemophilus
spp. And other gram negative bacteria • Viral infections less
common, can be caused by HSV, adenovirus, enterovirus.

4. CONTD……
The most common bacteria that can cause serious eye
damage are gonorrhea and chlamydia, which can be
passed from mother to child during birth.
The viruses that cause genital and oral herpes may
also be passed to the baby during childbirth, and may
lead to severe eye damage. 
The mother may not have symptoms at the time of
delivery. Yet she still may carry bacteria or viruses
that can cause conjunctivitis in the newborn.

5. SYMPTOMS
Infected newborn infants develop drainage from
the eyes within 1 day to 2 weeks after birth.
The eyelids become puffy, red, and tender.
There may be watery, bloody, or thick pus-like
drainage from the infant's eyes.

6. DIAGNOSIS
The health care provider will perform an eye
exam on the baby. If the eye does not appear
normal, the following tests may be done:
Culture of the drainage from the eye to look for
bacteria or viruses

7. TREATMENT
Prophylaxis needs antenatal, natal, and post-
natal care.
Antenatal measures include thorough care of mother
and treatment of genital infections when suspected.
Natal measures are of utmost importance as mostly
infection occurs during childbirth. Deliveries should be
conducted under hygienic conditions taking all aseptic
measures. The newborn baby's closed lids should be
thoroughly cleansed and dried.

8. CONTD…..
Postnatal measures include:
Use of 1% tetracycline ointment or 0.5% erythromycin
ointment or 1% silver nitrate solution into the eyes of
babies immediately after birth
Single injection of ceftriaxone 50 mg/kg IM or IV
should be given to infants born to mothers with
untreated gonococcal infection.
Curative treatment as a rule, conjunctival cytology
samples and culture sensitivity swabs should be taken
before starting treatment.

9. GONOCOCCAL OPHTHALMIA
NEONATORUM
It needs prompt treatment to prevent
complications. Topical therapy should include
Saline levarage hourly till the discharge is eliminated
Bacitracin eye ointment four times per day (Because of
resistant strains topical penicillin therapy is not
reliable.
 However in cases with proved penicillin
susceptibility, penicillin drops 5000 to 10000 units per
ml should be instilled every minute for half an hour,
every five minutes for next half an hour and then half-
hourly till infection is controlled)
If the cornea is involved then atropine sulphate
ointment should be applied.

10. SYSTEMIC THERAPY: NEONATES WITH
GONOCOCCAL OPHTHALMIA
NEONATORUM SHOULD BE TREATED
FOR SEVEN DAYS WITH ONE OF THE
FOLLOWING REGIMENS
1.Ceftriaxone 75–100 mg/kg/day IV or IM, QID
2.Cefotaxime 100–150 mg/kg/day IV or IM, 12 hourly
3.Ciprofloxacin 10–20 mg/kg/day or Norfloxacin
10 mg/kg/day

11. CONTD…..
4. Crystalline benzyl penicillin G 50,000 units
(for full-term normal weight babies) or 20,000
units (for premature or low weight babies) IM
twice daily for three days (if the organism is
penicillin susceptible)

12. Expectations (prognosis)
Early diagnosis of infected mothers and good
preventive practices at hospitals have made this
problem much less common in newborns. Quick
diagnosis and treatment usually leads to good
outcomes.

13. Complications
Blindness
Inflammation of the iris
Scar or hole in the cornea--the clear structure
that is over the colored part of the eye (the iris)

14. Prevention
Treating a pregnant woman for sexually
transmitted diseases will prevent conjunctivitis
caused by these infections in her newborn.
When a mother has active herpes sores at the
time of delivery, a cesarean section is
recommended to prevent serious illness in the
baby.