Conjunctivitis (peds)

Presentation is most consistent with bacterial conjunctivitis.
Will empirically treat:
– Given walking age and this medication is a solution and will causes less blurry vision, Polymyxin B/Trimethoprim (Polytrim) 2 drops every 6 hours for 7 days
– Given pre-walking age this medication is an oinment and will be more easily administered and annoyance of blurry vision less of a concern given pt is non-walking, Erythromycin ointment applied to the conjunctiva q6hrs for 7 days
DDx (I considered that there is a small but finite risk for the following processes. The patient’s symptoms, signs and vclinical evaluation do not meet our criteria (reasonable level of consistency with characteristic findings) for additional pursuit of these entities at this time:
-viral conjuncitivis – posssible though will empirically treat for bacterial cause given hx/exam suggest features of bacterial infection and relatively low risk of empiric treatment
-corneal abrasion – unlikely given hx of no injury/scrape to eyes and no eye pain objectively seen while pt in ED.
-no evidence of otitis media on hx/exam therefore treatment for h. inlfuenza not indicated at this time
(therefore deferred augmentin (amoxicillin/clavulonic acid 600mg-43mg/5mL at 80-90 mg/kg/day BID). Advised for recheck of ears by PMD for f/u.
-clamydial/gonorrheal infection – unlikely given pt’s age is greater than 1 month of age and epidemiologically unlikely
No evidence of systemic infection, pt well appearing, appropriate for outpatient management. Advised for prompt f/u with PMD for re-eval and return precautions disucssed.

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