Ophthalmia Neonatorum
A 2-week-old baby girl with a 3-day history of purulent discharge from both eyes was brought by her parents to the ophthalmology clinic. The baby had been born at full term by means of spontaneous vaginal delivery. She had not received ocular prophylaxis after delivery, and the mother had not undergone prenatal testing for chlamydia or gonorrhea infection. An eye-discharge sample obtained from the baby and an endocervical swab obtained from the mother tested positive for Chlamydia trachomatisDNA and negative for Neisseria gonorrhoeae DNA by polymerase chain reaction. Perinatal transmission of C. trachomatis or N. gonorrhoeaecan result in neonatal conjunctivitis, known as ophthalmia neonatorum. The ongoing incidence of ophthalmia neonatorum caused by C. trachomatis or N. gonorrhoeae can be addressed by routine maternal prenatal screening for and treatment of sexually transmitted infections and by postpartum neonatal ocular prophylaxis against N. gonorrhoeae. In addition to treatment of the baby, which included a 2-week course of oral erythromycin, a single dose of oral azithromycin was given to each parent. The baby’s symptoms resolved within 5 days after the initiation of treatment, and she remained healthy at follow-up 2 weeks later.