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Revision as of 09:57, 30 October 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:

Synonyms and keywords: Conjunctivitis in kids

Overview

Conjunctivitis is characterized by inflammation and swelling of the conjunctival tissue which can be associated with engorgement of the blood vessels, ocular discharge, and pain. Neonatal conjunctivitis is a red eye in a newborn caused by infection, irritation, or a blocked tear duct. When caused by an infection, neonatal conjunctivitis can be very serious.

Historical Perspective

Neonatal conjunctivitis was first described by S.T. Quellmaz in 1750.^[1]^[2]
Crédé introduced 2% silver nitrate for the first time as a prophylaxis treatment method for conjunctivitis in the newborns in 1881. In 1883, Koch discovered the bacilli of two different forms of infectious conjunctivitis.
In 1953, Micheal Hogan first described the association between atopic dermatitis and conjunctivitis.

Classification

Conjunctivitis can be classified into subtypes:^[3]

Pathophysiology

The surface tissues of the eye and the ocular adnexa are colonized by normal flora such as streptococci, staphylococci and corynebacteria. Alterations in the bacterial titer, or in the species of bacteria can lead to clinical infection. Alteration in the flora can also result from external contamination, the use of topical or systemic antibiotics, or spread from adjacent infectious sites.
Disruption of defense barriers can lead to infection. The primary defense against infection is the epithelial layer covering the conjunctiva. Secondary defense include hematologic immune mechanisms carried by the conjunctival vessels, tear film immunoglobulins and lysozyme and the rinsing action of lacrimation and blinking.^[4]

Causes

Neonatal conjunctivitis^[5]

Conjunctivitis in children^[5]^[6]

Differentiating conjunctivitis from other Diseases

In children with red eye and conjunctivitis symptoms, mentioned diagnosis should be excluded:^[7]

Epidemiology and Demographics

Bacterial conjunctivitis predominantly occurs in children <6 years of age. Recent studies have confirmed that haemophilus influenzae and streptococcus pneumoniae are the two organisms most commonly responsible for bacterial conjunctivitis in children.
Viral conjunctivitis occurs most often in the fall and winter and usually affects children older than 6 years.
Boys and girls are affected in similar proportions.^[5]

Risk Factors

Risk factors of neonatal conjunctivitis includes:^[8]^[9]

STDs in mother
HIV infected mothers
Exposure of the infant to infectious organisms
Prematurity
Poor hygienic delivery conditions
Ocular trauma during delivery

Natural History, Complications and Prognosis

The majority of patients with [disease name] remain asymptomatic for [duration/years].
Early clinical features include [manifestation 1], [manifestation 2], and [manifestation 3].
If left untreated, [#%] of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
Prognosis is generally [excellent/good/poor], and the [1/5/10year mortality/survival rate] of patients with [disease name] is approximately [#%].

Diagnosis

Diagnostic Criteria

The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met:

[criterion 1]
[criterion 2]
[criterion 3]
[criterion 4]

Symptoms

[Disease name] is usually asymptomatic.
Symptoms of [disease name] may include the following:

[symptom 1]
[symptom 2]
[symptom 3]
[symptom 4]
[symptom 5]
[symptom 6]

Physical Examination

Patients with [disease name] usually appear [general appearance].
Physical examination may be remarkable for:

[finding 1]
[finding 2]
[finding 3]
[finding 4]
[finding 5]
[finding 6]

Laboratory Findings

There are no specific laboratory findings associated with [disease name].

A [positive/negative] [test name] is diagnostic of [disease name].
An [elevated/reduced] concentration of [serum/blood/urinary/CSF/other] [lab test] is diagnostic of [disease name].
Other laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].

Electrocardiogram

There are no ECG findings associated with [disease name].

OR

An ECG may be helpful in the diagnosis of [disease name]. Findings on an ECG suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

X-ray

There are no x-ray findings associated with [disease name].

OR

An x-ray may be helpful in the diagnosis of [disease name]. Findings on an x-ray suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no x-ray findings associated with [disease name]. However, an x-ray may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].

Echocardiography or Ultrasound

There are no echocardiography/ultrasound findings associated with [disease name].

OR

Echocardiography/ultrasound may be helpful in the diagnosis of [disease name]. Findings on an echocardiography/ultrasound suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no echocardiography/ultrasound findings associated with [disease name]. However, an echocardiography/ultrasound may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].

CT scan

There are no CT scan findings associated with [disease name].

OR

[Location] CT scan may be helpful in the diagnosis of [disease name]. Findings on CT scan suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no CT scan findings associated with [disease name]. However, a CT scan may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].

MRI

There are no MRI findings associated with [disease name].

OR

[Location] MRI may be helpful in the diagnosis of [disease name]. Findings on MRI suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no MRI findings associated with [disease name]. However, a MRI may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].

Other Imaging Findings

There are no other imaging findings associated with [disease name].

OR

[Imaging modality] may be helpful in the diagnosis of [disease name]. Findings on an [imaging modality] suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

Other Diagnostic Studies

[Disease name] may also be diagnosed using [diagnostic study name].
Findings on [diagnostic study name] include [finding 1], [finding 2], and [finding 3].

Treatment

Medical Therapy

There is no treatment for [disease name]; the mainstay of therapy is supportive care.

The mainstay of therapy for [disease name] is [medical therapy 1] and [medical therapy 2].
[Medical therapy 1] acts by [mechanism of action 1].
Response to [medical therapy 1] can be monitored with [test/physical finding/imaging] every [frequency/duration].

Surgery

Surgery is the mainstay of therapy for [disease name].
[Surgical procedure] in conjunction with [chemotherapy/radiation] is the most common approach to the treatment of [disease name].
[Surgical procedure] can only be performed for patients with [disease stage] [disease name].

Prevention

There are no primary preventive measures available for [disease name].

Effective measures for the primary prevention of [disease name] include [measure1], [measure2], and [measure3].

Once diagnosed and successfully treated, patients with [disease name] are followed-up every [duration]. Follow-up testing includes [test 1], [test 2], and [test 3].

References

↑ "Reports from the obstetrical clinic in Leipzig. Prevention of eye inflammation in the newborn". Am J Dis Child. 121 (1): 3–4. 1971. PMID 5543850.
↑ Mallika P, Asok T, Faisal H, Aziz S, Tan A, Intan G (2008). "Neonatal conjunctivitis - a review". Malays Fam Physician. 3 (2): 77–81. PMC 4170304. PMID 25606121.
↑ Gigliotti F, Williams WT, Hayden FG, Hendley JO, Benjamin J, Dickens M; et al. (1981). "Etiology of acute conjunctivitis in children". J Pediatr. 98 (4): 531–6. doi:10.1016/s0022-3476(81)80754-8. PMID 6970802.
↑ Azari AA, Arabi A (2020). "Conjunctivitis: A Systematic Review". J Ophthalmic Vis Res. 15 (3): 372–395. doi:10.18502/jovr.v15i3.7456. PMC 7431717 Check |pmc= value (help). PMID 32864068 Check |pmid= value (help).
↑ ^5.0 ^5.1 ^5.2 Weiss A (1994). "Acute conjunctivitis in childhood". Curr Probl Pediatr. 24 (1): 4–11. doi:10.1016/0045-9380(94)90022-1. PMID 8174390.
↑ Bodor FF, Marchant CD, Shurin PA, Barenkamp SJ (1985). "Bacterial etiology of conjunctivitis-otitis media syndrome". Pediatrics. 76 (1): 26–8. PMID 3874389.
↑ Rainsbury PG, Cambridge K, Selby S, Lochhead J (2016). "Red eyes in children: red flags and a case to learn from". Br J Gen Pract. 66 (653): 633–634. doi:10.3399/bjgp16X688309. PMC 5198670. PMID 27884914.
↑ Gichuhi S, Bosire R, Mbori-Ngacha D, Gichuhi C, Wamalwa D, Maleche-Obimbo E; et al. (2009). "Risk factors for neonatal conjunctivitis in babies of HIV-1 infected mothers". Ophthalmic Epidemiol. 16 (6): 337–45. doi:10.3109/09286580903144746. PMC 3223245. PMID 19995198.
↑ Honkila M, Renko M, Ikäheimo I, Pokka T, Uhari M, Tapiainen T (2018). "Aetiology of neonatal conjunctivitis evaluated in a population-based setting". Acta Paediatr. 107 (5): 774–779. doi:10.1111/apa.14227. PMC 7159510 Check |pmc= value (help). PMID 29345007.

[pmid5543850-1] "Reports from the obstetrical clinic in Leipzig. Prevention of eye inflammation in the newborn". Am J Dis Child. 121 (1): 3–4. 1971. PMID 5543850.

[pmid25606121-2] Mallika P, Asok T, Faisal H, Aziz S, Tan A, Intan G (2008). "Neonatal conjunctivitis - a review". Malays Fam Physician. 3 (2): 77–81. PMC 4170304. PMID 25606121.

[pmid6970802-3] Gigliotti F, Williams WT, Hayden FG, Hendley JO, Benjamin J, Dickens M; et al. (1981). "Etiology of acute conjunctivitis in children". J Pediatr. 98 (4): 531–6. doi:10.1016/s0022-3476(81)80754-8. PMID 6970802.

[pmid32864068-4] Azari AA, Arabi A (2020). "Conjunctivitis: A Systematic Review". J Ophthalmic Vis Res. 15 (3): 372–395. doi:10.18502/jovr.v15i3.7456. PMC 7431717 Check |pmc= value (help). PMID 32864068 Check |pmid= value (help).

[pmid8174390-5] 5.0 ^5.1 ^5.2 Weiss A (1994). "Acute conjunctivitis in childhood". Curr Probl Pediatr. 24 (1): 4–11. doi:10.1016/0045-9380(94)90022-1. PMID 8174390.

[pmid3874389-6] Bodor FF, Marchant CD, Shurin PA, Barenkamp SJ (1985). "Bacterial etiology of conjunctivitis-otitis media syndrome". Pediatrics. 76 (1): 26–8. PMID 3874389.

[pmid27884914-7] Rainsbury PG, Cambridge K, Selby S, Lochhead J (2016). "Red eyes in children: red flags and a case to learn from". Br J Gen Pract. 66 (653): 633–634. doi:10.3399/bjgp16X688309. PMC 5198670. PMID 27884914.

[pmid19995198-8] Gichuhi S, Bosire R, Mbori-Ngacha D, Gichuhi C, Wamalwa D, Maleche-Obimbo E; et al. (2009). "Risk factors for neonatal conjunctivitis in babies of HIV-1 infected mothers". Ophthalmic Epidemiol. 16 (6): 337–45. doi:10.3109/09286580903144746. PMC 3223245. PMID 19995198.

[pmid29345007-9] Honkila M, Renko M, Ikäheimo I, Pokka T, Uhari M, Tapiainen T (2018). "Aetiology of neonatal conjunctivitis evaluated in a population-based setting". Acta Paediatr. 107 (5): 774–779. doi:10.1111/apa.14227. PMC 7159510 Check |pmc= value (help). PMID 29345007.

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@@ Line 9: / Line 9: @@
 ==Historical Perspective==
+* Neonatal [[conjunctivitis]] was first described by S.T. Quellmaz in 1750.<ref name="pmid5543850">{{cite journal| author=| title=Reports from the obstetrical clinic in Leipzig. Prevention of eye inflammation in the newborn. | journal=Am J Dis Child | year= 1971 | volume= 121 | issue= 1 | pages= 3-4 | pmid=5543850 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=5543850  }} </ref><ref name="pmid25606121">{{cite journal| author=Mallika P, Asok T, Faisal H, Aziz S, Tan A, Intan G| title=Neonatal conjunctivitis - a review. | journal=Malays Fam Physician | year= 2008 | volume= 3 | issue= 2 | pages= 77-81 | pmid=25606121 | doi= | pmc=4170304 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25606121  }} </ref>
+* Crédé introduced 2% silver [[nitrate]] for the first time as a prophylaxis treatment method for [[conjunctivitis]] in the [[newborns]] in 1881. In 1883, Koch discovered the [[bacilli]] of two different forms of infectious [[conjunctivitis]].
+* In 1953, Micheal Hogan first described the association between [[atopic dermatitis]] and [[conjunctivitis]].
-*[Disease name] was first discovered by [scientist name], a [nationality + occupation], in [year] during/following [event].
-*In [year], [gene] mutations were first identified in the pathogenesis of [disease name].
-*In [year], the first [discovery] was developed by [scientist] to treat/diagnose [disease name].
 ==Classification==
 [[Conjunctivitis]] can be classified into subtypes:<ref name="pmid6970802">{{cite journal| author=Gigliotti F, Williams WT, Hayden FG, Hendley JO, Benjamin J, Dickens M | display-authors=etal| title=Etiology of acute conjunctivitis in children. | journal=J Pediatr | year= 1981 | volume= 98 | issue= 4 | pages= 531-6 | pmid=6970802 | doi=10.1016/s0022-3476(81)80754-8 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6970802  }} </ref>