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A 3 week old male infant is brought to the office for the evaluation for the red eyes.His temperature is 99F, pulse 100/minute and RR 34/min.On examination , the infant has conjunctival congestion and scant mucoid discharge.The rest of the physical examination is normal.What is the most appropriate next step in the management of this pt?
A-Topical erythromycin
B-Topical silver nitrate
C-Topical steroids
D-oral erythromycin
E-oral tetracyclin
please explain ur answer.thanks
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chlamydia trachoma with follicular conjunctivitis,,,D,,,and sorry if it is wrong
pulse 100/ minute=conjunctivitis with bacterimia
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I think D is correct raheem. It is Chamydial infection. Oral erythromycin is given to treat both conjuctivitis as well as prevent chlamydial pneumonia .
(Neisseria gonococcal conjuctivitis presents with copious purulent discharge within the first 2 or 3days after birth.)
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Answer is D... oral erythromycin. But can you please tell me if there is any special reason to give the drug per oral? Thank you.
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And why not topical? Cause somewhere I have seen that topical erythromycin is also given. Thanks.
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Ans. D-oral erythromycin
Management for Neonatal Inclusion Conjunctivitis (NIC), caused by ,Chlamydia trachomatis
Erythromycin 50 mg/kg/day divided qid for 14 days.
But for Prevention,
Erythromycin or Tetracycline ophthalmic ointment -Applied to newborns eyes within 1 hour of delivery.
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D is correct as explained by usmedipro.thanks
it is also stated in kaplan micro under chlamydia prevention that
"treat neonatal conjunctivitis with SYSTEMIC erythromycin to prevent pneumonia."
Oral Tetaracylin also function against chlamydia But contraindicated in children
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well, if there is a choice that says oral and topical erythromycin, then that is the ideal answer drock.
If either one of them is given as separate answer choices, then oral erythro is the right choice.
It is presumed that if a child develops scant mucoid discharge on weeks 2 or 3, suggestive of chlamydial conjunctivitis, then the baby is more likely to develop chlamydial pneumonia also. So we give both and most importantly oral erythro for therapy and prophylaxis !
