Which of the following is the most common cause of ophthalmic neonatorum?

AIIMS Patna NO - 2020

Child Health Nursing (Pediatrics)

Easy

Appeared in: AIIMS Patna NO - 2020

Explanation

Neisseria gonorrhoeae is a gram-negative bacterium transmitted from an infected mother to the infant during vaginal delivery.
It causes a hyperacute form of conjunctivitis, characterized by profuse purulent discharge, significant eyelid edema, and redness, typically appearing 2-5 days after birth.
Gonococcal ophthalmia is a medical emergency because the infection can rapidly invade the cornea, leading to ulceration, perforation, and permanent blindness if not treated promptly with systemic antibiotics.
Among the options provided, it is considered the most significant and classic cause of severe neonatal conjunctivitis.

Option A: Candida albicans is a fungus, not a bacterium. Fungal conjunctivitis in newborns is very rare and is not a common cause of ophthalmia neonatorum.
Option B: Staphylococcus aureus can cause neonatal conjunctivitis, but it typically results in a milder infection compared to the hyperacute and destructive process caused by Neisseria gonorrhoeae.
Option D: Various species of Streptococcus can cause neonatal infections, including conjunctivitis, but they are less common and typically cause a less severe disease than Neisseria gonorrhoeae.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Etiology of Ophthalmia Neonatorum as background academic context rather than a clinical decision trigger.
The prevention of ophthalmia neonatorum is a key nursing responsibility. Administering prophylactic antibiotic eye ointment (e.g., erythromycin) to all newborns after birth is a standard of care.
Nurses must be vigilant in assessing newborns for any eye discharge, redness, or swelling. Any signs of conjunctivitis must be reported immediately for prompt diagnosis and treatment.
Patient education is crucial. Nurses should educate expectant mothers about the importance of screening and treatment for sexually transmitted infections (STIs) during pregnancy to prevent transmission to the baby.

How to Approach the Question

First, identify the core concept in the question stem: 'ophthalmia neonatorum' and the specific question: 'most common cause'.
Recall that ophthalmia neonatorum is conjunctivitis in a newborn, typically acquired from the mother's birth canal.
Review the options, which are all infectious organisms. Your task is to identify the one most strongly associated with this condition.
Even if you know Chlamydia is the most frequent cause overall, it is not an option. Therefore, you must evaluate the given choices.
Compare the remaining options. Neisseria gonorrhoeae is the classic, most severe cause of ophthalmia neonatorum, capable of causing blindness. This makes it the most significant and likely correct answer in an exam context when Chlamydia is absent.
Eliminate the other options: Candida is a rare fungal cause, while Staphylococcus and Streptococcus cause milder or less common forms of neonatal conjunctivitis.

Concept Tested & Keywords

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E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 1747-1749

E6 Text Book Of Pediatric Nursing 3rd Panchali Pal — Part 1 (pp 36-238 of 713) p. 198-200

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