Fracture shaft of Femur：股骨干骨折.pptVIP

Extern Conference Ophthalmia Neonatorum A 17-day-old female term newborn CC: purulent discharge from Rt eye for 3 days PI: 7 d PTA, Rt eye showed whitish-grey watery discharge and tear but no eyelid swelling was detected. 3 d PTA, Rt eyelids were red and swelled with occasional bloody-purulent discharge. She was treated by topical ATB and eye irrigation with sterile water but these symptoms did not improve. She had no fever, no drowsiness, no URI symptoms. She was breast-fed well. Birth history: G1P0A0, GA 38 wks, NL, Apgar 10,10 BW 3,090 g, length 50 cm, HC 33 cm There was no complication after delivery. History of pregnancy: serology : neg no maternal history of STD amniotic membrane ruptured 7 hr before delivery mother had no fever or vaginal discharge. Family history: no genetic or contagious disease No history of drug allergy Vaccine: BCG, HBV1 Physical examination BW 3,700 g (P50-75), length 54 cm (P75-90). HC 35 cm (P50) V/S: T 36.8°C, P 168/min, R 40/min GA: active and non-toxic child, not irritable, not pale, no jx, no dyspnea, no signs of dehydration HEENT: pharynx and tonsils are not injected Rt eye: red and mildly swollen eyelid, marked conjunctival injection with purulent and bloody discharge, clear cornea, EOM and VA cannot be evaluated Lt eye : normal Physical examination CVS: normal S1, S2, no murmur RS: normal breath sound, no adventitious sound Abd: soft, not tender, no hepatosplenomegaly NS: normal movement, Brudzinski’s sign negative Problem list 1. Unilateral purulent discharge (Rt eye) 2. Mild eyelid swelling with marked conjunctival injection (Rt eye) Differential Diagnosis Ophthalmia neonatorum (neonatal conjunctivitis) Neonatal dacryocystitis Periorbital cellulitis Differential Diagnosis Ophthalmia neonatorum Neonatal conjunctivitis – during the first mo Aseptic – chemical: silver nitrate Septic – bacteria, chlamydia, virus Septic neonatal conjunctivitis Neisseria gonorrhoeae (GC) –