## Neonatal Bacterial Conjunctivitis — Epidemiology **Key Point:** Neisseria gonorrhoeae remains the most common bacterial cause of acute purulent conjunctivitis (ophthalmia neonatorum) in neonates in India, despite prophylaxis protocols. ### Causative Organisms in Neonatal Conjunctivitis | Organism | Onset | Presentation | Severity | Prevalence in India | | --- | --- | --- | --- | --- | | **N. gonorrhoeae** | 2–5 days | Profuse purulent discharge, lid edema, chemosis | High (risk of corneal scarring/blindness) | Most common | | **C. trachomatis** | 5–14 days | Mucopurulent discharge, follicles | Moderate | Common | | **S. aureus** | 5–7 days | Mild to moderate purulence | Mild to moderate | Less common | | **S. pneumoniae** | Variable | Mild purulent discharge | Mild | Rare | **High-Yield:** Gonococcal conjunctivitis is a medical emergency — untreated infection can lead to corneal perforation, pannus formation, and permanent blindness within 2–3 days. Immediate systemic and topical antibiotics are mandatory. ### Clinical Pearl Although Chlamydia trachomatis is common in developed countries, N. gonorrhoeae remains the leading cause of acute purulent neonatal conjunctivitis in India due to higher maternal prevalence and variable prophylaxis coverage. **Mnemonic: GCS** — **G**onorrhoeae (acute purulent, 2–5 days), **C**hlamydia (mucopurulent, 5–14 days), **S**taphylococcus (mild, variable). 
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