VERIFIED CONTENTAuthor: lek. Katarzyna Marciniuk

The Crede procedure is one of the first procedures routinely performed in newborns born both by force of nature and as a result of caesarean section. It has been carried out since 1880, spectacularly improving the statistics in gonococcal, chlamydial and viral conjunctivitis and keratitis and preventing their consequences in the youngest children.

Crede treatment - what is it and what is it?

The Crede treatmentconsists in the prophylactic administration of 1 drop of 1% silver nitrate to the conjunctival sac of a newborn. It is performed to prevent conjunctivitis caused by gonorrhea, chlamydia or viruses.

In newborns born naturally, infection may occur through contact with the woman's genital tract. Newborns delivered by cesarean section are to a lesser extent, albeit not completely free from the risk of contracting the disease. This can happen as a result of the premature departure of the amniotic fluid or as a result of the ascending path.

We live in the age of the availability of diagnostic tests and the possibility of treating infections, so you may wonder what prophylaxis is for? Intimate infections are difficult to treat, they may recur, may produce symptoms that are not very specific and obvious, and are mild, so women may not be aware of the infection.

Crede treatment - side effects

Chemical conjunctivitis may be a side effect of the conjunctival administration of silver nitrate. The conjunctiva of a newborn is a very sensitive and delicate structure, therefore such a complication is quite common. It manifests itself as a slight hyperemia and secretion of serous secretions, which lasts about 2-3 days. The diagnosis is made by the doctor after observing the characteristic symptoms and examining the anterior segment of the eye. Chemical conjunctivitis does not require treatment as it is a benign complication that undergoes spontaneous regression.

Crede treatment and gonococcal conjunctivitis

Before the Credego treatment was introduced, 1 in 100 newborns lost their eyesight as a result of infection. Currently, there is 1 case per year. It is worth knowing that the symptoms of gonococcal conjunctivitis appear between the 2nd and 4th day of life and are:

  • large swelling of the eyelids that prevents the eyes from opening
  • profuse greenish purulent discharge
  • extensive ulceration in the cornea
  • conjunctival redness
  • very fast development of changes

An untreated infection can result in corneal perforation, eyeball inflammation, and permanent blindness. In rare cases, the disease may cause generalized symptoms, such as sepsis, meningitis, arthritis.

The diagnosis is made by the doctor by examining the child, identifying the characteristic symptoms and performing bacteriological tests on the swabs taken.

The infection requires hospital treatment with intravenous and conjunctival antibiotics. Frequent eye hygiene is important - washing, collecting secretions. People who could be a source of infection should also be examined and treated.

As a result of properly conducted treatment, bacteria are removed from the body, however, very intense changes in the cornea may lead to scarring and visual impairment. In some cases, surgery to remove scar lesions may be necessary to restore visual acuity.

Crede treatment and herpes virus conjunctivitis

The Crede treatment protects newborns also against conjunctivitis caused by the herpes virus. Conjunctivitis of this etiology occurs when a newborn is infected with the herpes simplex virus type 2. Symptoms appear a little later than in the case of gonorrhea, about 5-12 days after delivery and these are:

  • profuse serous secretion
  • bubbles on the eyelids
  • eyelid swelling
  • conjunctival redness
  • keratitis with a characteristic tree-like ulcer

Intraocular and systemic changes are very rare and include: cataracts, uveitis, skin lesions, encephalitis.

In order to make a diagnosis, it is usually enough to find characteristic changes - vesicles on the eyelids and tree-shaped ulcers. Treatment consists of administering antiviral drops or ointments into the conjunctiva. In the case of generalized changes or inflammation in the eyeball, it may be necessary to administer systemic antiviral drugs - acyclovir.

Crede treatment and chlamydial conjunctivitis

The Crede treatment also protects newborns against chlamydial conjunctivitis. In Polandchlamydial conjunctival infectionis diagnosed quite rarely. The infection also occurs through contact with the infection in the reproductive tract of a pregnant woman during childbirth. Symptoms appear around 5-7day of life and include:

  • abundant mucus-purulent discharge
  • eyelid swelling
  • conjunctival redness
  • changes in the cornea in the form of the so-called pannus (found in an ophthalmological examination)

Chlamydia infection is chronic, lasting about 3 weeks (or more), and frequently recurring. Conjunctivitis may be accompanied by keratitis, pharyngitis, laryngitis, otitis, pneumonia.

The diagnosis is made after an ophthalmological examination, on the basis of characteristic symptoms and the result of a cytological examination of the material taken from the conjunctiva. The treatment consists in a combination of systemic antibiotic therapy (due to the frequent occurrence of symptoms from other organs) and antibiotics administered conjugally in the form of drops. Due to the recurrent nature of the infection, it is necessary to undergo ophthalmological check-ups in the child.

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