A 5-day-old newborn develops copious purulent bilateral ocular discharge. Gram stain of the exudate shows gram-negative intracellular diplococci. What is the correct management?
- A Topical tetracycline ointment alone every four hours
- B Topical gentamicin drops and oral amoxicillin for seven days
- C Single dose of ceftriaxone 25 to 50 mg/kg IV or IM plus frequent saline irrigation of the eyes ✓
- D Immediate corneal scraping for culture before any treatment is started
Correct answer: C. Single dose of ceftriaxone 25 to 50 mg/kg IV or IM plus frequent saline irrigation of the eyes
Explanation
Gonococcal ophthalmia neonatorum presents within the first week of life with profuse purulent discharge and can perforate the cornea within days. Treatment requires systemic therapy, a single dose of ceftriaxone 25 to 50 mg/kg IV or IM, combined with frequent saline irrigation to clear the exudate. Topical antibiotics alone are inadequate because the infection involves deeper ocular structures. Evaluation of the mother and treatment of her partner are also required, but treatment of the infant should never be delayed for culture results.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.