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EM Clerkship

Neonatal Conjunctivitis

EM Clerkship

Zack Olson, MD ; Mike Estephan, MD ; Maddie Watts, MD

Health & Fitness, Science, Education, Medicine, Life Sciences

4.9816 Ratings

🗓️ 3 June 2018

⏱️ 7 minutes

🧾️ Download transcript

Summary


The 3 Worst Causes of Neonatal Conjunctivitis



* Gonorrhea* Causes corneal ulcers and sepsis* Red flags* 1st week of life* Copious purulent drainage* Diagnose with cultures* Treatment* Cefotaxime (3rd generation cephalosporin)* Admit* Chlamydia* Occurs in 1st month of life* Treat with PO erythromycin* HSV* Can disseminate to the brain* Red flags* Mother tested positive (or had active lesions)* Vesicles on baby* Treatment* IV acyclovir* Admit



Other Causes of Conjunctivitis



* Viral/other bacterial* Treat with erythromycin ointment* Chemical conjunctivitis* Caused by eye drops given after birth* Dacryostenosis (closed eye ducts)* Watery eyes from tears not draining



Additional Reading



* Neonatal Conjunctivitis (CDC)

Transcript

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0:00.0

Hello, men students. My name is Zach Olson, and thank you for downloading this week's episode of the EM Clerkship Podcast.

0:12.6

More PEDs. We've got a quick high-yield peeds topic again this week. Should only take a few minutes.

0:19.8

Neonatal conjunctivitis. You're going to see it on your

0:24.4

peds rotation. You're going to see it on your EM rotation. And certainly on step one, step two,

0:29.2

you got to know this. What you need to know for emergency medicine, at least, are the bad causes,

0:37.1

of which there are three.

0:40.0

There are some other common causes as well, and we're going to go through them all.

0:45.5

But the one question you have to ask yourself, when you have a baby with conjunctiveitis,

0:52.3

did this baby get STDs in its eye? It's the grossest scenario. It's the worst

1:00.9

case scenario. You're concerned about sexually transmitted infections in the eye. That is your concern.

1:09.0

Sexually transmitted infections in the eye. Now, when you learn this

1:16.0

originally, it was probably in chronologic order. You learn that the prophylactic drops

1:23.4

caused red, draining eyes on that first day of life.

1:28.3

And then you learn that gonorrhea with that purulent drainage is in that first week.

1:35.3

And then that chlamydia is in that first month.

1:38.3

And that's how you probably learn this.

1:40.3

And that's kind of how I learned it too.

1:42.3

But now I think about it differently differently now that I'm a resident.

1:46.5

Again, what I want you to be thinking is did this kid get STDs in its eyeball? That's what matters.

1:55.8

Everything else is secondary to the venereal eyeball. Three STDs that you need to be concerned about.

2:03.4

And we're going to start with the worst.

2:07.7

Gonorrhea eyeball.

...

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