In the United States, which infection is the leading cause of Ophthalmia neonatorum?

• A. Gonorrhea infections
• B. HSV infections
• C. Staphylococcus aureus infections
• D. Chlamydia infections

Answer: (D)

Chlamydia trachomatis is the leading cause of ophthalmia neonatorum in the United States. This reflects the ongoing prevalence of maternal chlamydial infection and the effectiveness of newborn prophylaxis against gonococcal disease, which has reduced gonorrheal neonatal conjunctivitis. Clinically, chlamydial conjunctivitis tends to present later, about 5 to 14 days after birth, with mild to moderate mucopurulent discharge, and it can be associated with conjunctival inflammation and later respiratory involvement, whereas gonococcal infection, if it occurs, presents much earlier (within 2–5 days) as a severe, hyperacute purulent conjunctivitis with higher risk of corneal damage. HSV and Staphylococcus aureus can cause neonatal conjunctivitis too, but they are not the primary etiologies for ophthalmia neonatorum in the U.S.