Differential Diagnosis for Eye Discharge with Mild Erythema in a 2-Month-Old
- Single Most Likely Diagnosis
- Conjunctivitis (likely viral or bacterial): This is the most common cause of eye discharge in infants, often accompanied by mild erythema. The age of the patient and the presentation make this a highly probable diagnosis.
- Other Likely Diagnoses
- Nasolacrimal duct obstruction: This condition is common in infants and can cause eye discharge, especially if the duct is partially blocked. It might not always present with significant erythema.
- Allergic conjunctivitis: Although less common in infants, exposure to allergens can cause allergic reactions leading to eye discharge and mild erythema.
- Do Not Miss Diagnoses
- Gonococcal conjunctivitis: This is a serious condition that can lead to corneal perforation and blindness if not treated promptly. It's essential to consider this in the differential, especially if there's a history of maternal gonorrhea.
- Chlamydial conjunctivitis: Similar to gonococcal conjunctivitis, chlamydial infection can have severe consequences if not treated. It's a significant cause of conjunctivitis in newborns, acquired from an infected mother during birth.
- Herpes simplex virus (HSV) conjunctivitis: HSV can cause severe ocular and systemic disease in newborns. Early recognition and treatment are crucial to prevent long-term sequelae.
- Rare Diagnoses
- Congenital glaucoma: Although rare, it can present with eye discharge, photophobia, and blepharospasm. The mild erythema might be part of the presentation, but it's more commonly associated with other symptoms like corneal clouding.
- Sjögren's syndrome: Extremely rare in infants, but it could be considered in the context of systemic symptoms and specific autoantibodies.
- Leukocoria-associated conditions (e.g., retinoblastoma): While these conditions primarily present with a white pupillary reflex, in rare cases, they might also cause secondary conjunctivitis or eye discharge due to tumor necrosis or secondary infection.