A1 - Ant Seg Infections

Question 1

Ophthalmia neonatorum

Answer 1

Conj-itis occuring in 1st mo of life

Viral, bacterial, or chemical agents
Thru direct contact - if infection ascends into uterus, even C-section infant can be affected

Prophylaxis = erythromycin “gooped” on eye after birth (covers Chlamydia and N. gonorrhea)

• common in areas of high prevalence of STDs, poor health
• used to use silver nitrate

Question 2

Neisseria gonorrhea

Answer 2

Can cause ophthalmia neonatorum

Seen in 1st 3-4 days

Mild conj hyperemia and discharge, even marked chemosis, copious discharge, potential for K ulceration

Tx: systemic antibiotics, topical saline irrigation
-topical antibiotics if K involvement

Question 3

Congenital herpes simplex

Answer 3

HSV2

2nd week of life

Conj-itis, keratitis (epi or stromal), cataracts

Vesicular lesions, CNS involvement, retinal necrosis

Question 4

Bacterial conjunctivitis

Answer 4

Copious discharge

Dx by clinical presentation

Culture for severe caess

Topical agents (polymyxin combos, erythromycin, bacitracin, fluoros)

Question 5

Trachoma

Answer 5

Chlamydial

Poor hygiene/sanitation

Spreads eye to eye, flies can carry

Acute purulent conj-itis, follicular reaction, tarsal scarring, papillae hypertrophy, vasclarization of cornea

Culture for dx

Tx with topical and systemic erythromycin
-tetracycline can be used if older than 8 years

Question 6

Epidemic keratoconjunctivitis

• presentation
• initial symptoms
• later symptoms

Answer 6

Acute, bilateral follicular conj-itis
Preauricular adenopathy

FBS and periorbital pain

Diffuse superficial keratitis -> focal epithelial lesions
After 11-15 days, subepithelial opacities form under focal epi infiltrates

Question 7

Epidemic keratoconjunctivitis

• prognosis
• severe cases
• ddx
• complications

Answer 7

Opactiies can last 2 years

Pseudomembranes can form with marked eyelid swelling (peel off)

Ddx: orbital and preseptal cellulitis

Persistent subepi opacities, conj scarring

Question 8

Epidemic keratoconjunctivitis

• dx
• tx

Answer 8

Clinical presentation
Confirmed by rapid culture

Supportive - artif tears every hour, cool compresses
Topical steroids - with caution in severe cases (decr vision from subepi opac) *do not use with active EKC!