Conjunctivitis in children: Difference between revisions

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==Natural History, Complications and Prognosis==
==Natural History, Complications and Prognosis==


*The majority of patients with [disease name] remain asymptomatic for [duration/years].
===Natural history===
*Early clinical features include [manifestation 1], [manifestation 2], and [manifestation 3].
* [[Chlamydial conjunctivitis]] is cuased by [[chlamydia trachomatis]] which is one of the most common causes in neonatal [[conjunctivitis]]. Women with untreated [[chlamydia]] can pass the [[bacteria]] to her baby during childbirth. Symptoms include [[red eye]], [[swelling]] of the eyelids, and [[purulent]] discharge. Symptoms are likely to appear 5 to 12 days after birth. About half of[[ newborns]] with [[chlamydial conjunctivitis]] also have the infection in other parts of their bodies.<ref name="pmid30007329">{{cite journal| author=Zikic A, Schünemann H, Wi T, Lincetto O, Broutet N, Santesso N| title=Treatment of Neonatal Chlamydial Conjunctivitis: A Systematic Review and Meta-analysis. | journal=J Pediatric Infect Dis Soc | year= 2018 | volume= 7 | issue= 3 | pages= e107-e115 | pmid=30007329 | doi=10.1093/jpids/piy060 | pmc=6097578 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30007329  }} </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><ref name="pmid8174390">{{cite journal| author=Weiss A| title=Acute conjunctivitis in childhood. | journal=Curr Probl Pediatr | year= 1994 | volume= 24 | issue= 1 | pages= 4-11 | pmid=8174390 | doi=10.1016/0045-9380(94)90022-1 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8174390  }} </ref>
*If left untreated, [#%] of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
* [[Gonococcal conjunctivitis]] is caused by [[neisseria gonorrhoeae]]. Women with untreated [[gonorrhea]] can pass the [[bacteria]] to her baby during childbirth. Symptoms usually include [[red eye]], thick pus in the eyes, and [[swelling]] of the eyelids. This type of [[conjunctivitis]] usually begins about 2 to 4 days after birth. It can be associated with  [[bacteremia]] and [[meningitis]] in [[newborns]].
*Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
* Chemical [[conjunctivitis]] can occurs when eye drops are given to [[newborns]] or children to help prevent a [[bacterial]] infections. Symptoms of chemical [[conjunctivitis]] usually include mildly [[red eye]] and some [[swelling]] of the eyelids. Symptoms are likely to last for only 24 to 36 hours.
*Prognosis is generally [excellent/good/poor], and the [1/5/10­year mortality/survival rate] of patients with [disease name] is approximately [#%].
* [[Conjunctivitis]] caused by [[adenovirus]] is frequently [[hemorrhagic]], and cases of [[adenovirus]] [[keratoconjunctivitis]] are often accompanied by dramatic degrees of [[periorbital]] swelling.
 
===Complications===
Complications to neonatal [[conjunctivitis]] include:<ref name="pmid3084664">{{cite journal| author=Fransen L, Nsanze H, Klauss V, Van der Stuyft P, D'Costa L, Brunham RC | display-authors=etal| title=Ophthalmia neonatorum in Nairobi, Kenya: the roles of Neisseria gonorrhoeae and Chlamydia trachomatis. | journal=J Infect Dis | year= 1986 | volume= 153 | issue= 5 | pages= 862-9 | pmid=3084664 | doi=10.1093/infdis/153.5.862 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3084664  }} </ref><ref name="pmid21733975">{{cite journal| author=Drug and Therapeutics Bulletin| title=Management of acute infective conjunctivitis. | journal=Drug Ther Bull | year= 2011 | volume= 49 | issue= 7 | pages= 78-81 | pmid=21733975 | doi=10.1136/dtb.2011.02.0043 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21733975  }} </ref>
* [[Pseudomembrane]] formation
* [[Corneal]] edema
* Peripheral [[pannus]] formation
* [[Corneal]] [[opacification]]
* [[Corneal]] [[perforation]]
* [[Endophthalmitis]]
* Loss of eye and blindness
* Infantile [[pneumonia]]
* [[Nasopharyngeal]], [[rectal]]and [[vaginal]] colonization
* Some systemic complications particularly in [[gonococcal conjunctivitis]] including:
** [[Stomatitis]]
** [[Arthritis]]
** [[Rhinitis]]
** [Septicemia]]
** [[Meningitis]]
Complications of [[viral conjunctivitis]] in children including:<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>
* [[Keratitis]]
* [[Corneal]] ulceration with [[keratoconjunctivitis]]
 
===Prognosis===
* Early detection and early treatment of extremely pathogenic bacteria, such as [[Chlamydia trachomatis]] or [[Neisseria gonorrhoeae]], is associated with a good prognosis. <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>


==Diagnosis==
==Diagnosis==

Revision as of 10:41, 30 October 2020

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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

Classification

Conjunctivitis can be classified into subtypes:[3]

Pathophysiology

Causes

Differentiating conjunctivitis from other Diseases

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

Epidemiology and Demographics

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

Natural history

Complications

Complications to neonatal conjunctivitis include:[11][12]

Complications of viral conjunctivitis in children including:[2]

Prognosis

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

  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.
  2. 2.0 2.1 2.2 2.3 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.
  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.
  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).
  5. 5.0 5.1 5.2 5.3 Weiss A (1994). "Acute conjunctivitis in childhood". Curr Probl Pediatr. 24 (1): 4–11. doi:10.1016/0045-9380(94)90022-1. PMID 8174390.
  6. Bodor FF, Marchant CD, Shurin PA, Barenkamp SJ (1985). "Bacterial etiology of conjunctivitis-otitis media syndrome". Pediatrics. 76 (1): 26–8. PMID 3874389.
  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.
  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.
  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.
  10. Zikic A, Schünemann H, Wi T, Lincetto O, Broutet N, Santesso N (2018). "Treatment of Neonatal Chlamydial Conjunctivitis: A Systematic Review and Meta-analysis". J Pediatric Infect Dis Soc. 7 (3): e107–e115. doi:10.1093/jpids/piy060. PMC 6097578. PMID 30007329.
  11. Fransen L, Nsanze H, Klauss V, Van der Stuyft P, D'Costa L, Brunham RC; et al. (1986). "Ophthalmia neonatorum in Nairobi, Kenya: the roles of Neisseria gonorrhoeae and Chlamydia trachomatis". J Infect Dis. 153 (5): 862–9. doi:10.1093/infdis/153.5.862. PMID 3084664.
  12. Drug and Therapeutics Bulletin (2011). "Management of acute infective conjunctivitis". Drug Ther Bull. 49 (7): 78–81. doi:10.1136/dtb.2011.02.0043. PMID 21733975.