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Pyogenic eye of newborn

Introduction
Cause
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Diagnosis

Introduction

Introduction Neonatal pyorrhea is a hyperacute bacterial conjunctivitis caused by gonococcal infection, which is also called "gonococcal conjunctivitis" in medicine.

Cause

Cause

The cause of the disease is mainly caused by infection of the vaginal secretions of the mother with gonococcal vaginitis at birth. In addition, it can also be infected through other routes. The child usually develops both eyes at 2 to 4 days after birth, and the disease develops very rapidly. It is afraid of light, tearing, high edema of the eyelids and conjunctiva, and severe conjunctival edema and prominent eye cracks. The secretion of the eye of the child begins to be serous, and then quickly turns into purulent, a large amount of yellow pus continuously flows out of the eye crack, the child has difficulty blinking, and in severe cases, corneal ulcer and corneal leukoplakia may be complicated. The disease seriously affects the child's vision, and even corneal ulcer perforation and total ocular inflammation can lead to blindness, and may also be associated with purulent inflammation in other parts of the body, such as arthritis, meningitis, pneumonia, sepsis.

Examine

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Diagnosis can be made by conjunctival sac culture, immunofluorescein-labeled antibody or immunolabeling.

Diagnosis

Differential diagnosis

Clinically, the disease is divided into adult gonococcal conjunctivitis and neonatal gonococcal conjunctivitis.

Adult gonococcal conjunctivitis has a short incubation period of several hours to three days. Usually start from one side, but most of them involve both eyes, the onset is rapid, the condition is progressive development, eye pain, photophobia, tearing and other symptoms are obvious, eyelids are highly swollen, painful, with conjunctival hypercongestion, with small bleeding points and false Membrane formation, bulbar conjunctival edema, severe protrusion in the cleft palate, swollen lymph nodes in front of the ear, severe patients may even have suppuration of the lymph nodes in the ear. The disease is characterized by a large amount of secretions, the early secretions are serous or bloody, and the presence of diplococcus in the cytoplasm of the conjunctival smear epithelial cells; after 3 to 5 days, the swelling of the eyelids is relieved, and a large amount of purulent secretions appear. Continuously flow from the conjunctival sac, forming a typical pus phenomenon. At this time, there are a large number of gonococcal bacteria in the secretion; after 2 to 3 weeks, the purulent secretion gradually decreases, the conjunctival edema subsides, the palpebral conjunctiva is highly hypertrophy, and the nipple is hyperplasia. After a few months, the inflammation eventually subsides and a deep scar can be left on the conjunctiva.

Neonatal gonococcal conjunctivitis is the main cause of neonatal ophthalmia. Most of them are infected by the mother's birth canal. The incidence rate is about 0.04%, and the incubation period is 2 to 4 days. Both eyes are involved at the same time. The clinical manifestations are similar to those of adults. It is severe acute suppurative conjunctivitis, but the clinical process is milder than that of adults. The corneal complication is less than that of adults and it is late and light. However, if the treatment is not timely, corneal ulcers and perforations will occur. It affects vision because it occurs in the center of the cornea.