Differential Diagnosis for Purulent Discharge Bilaterally
- Single Most Likely Diagnosis
- Conjunctivitis: This is the most common cause of purulent discharge bilaterally, often due to a viral or bacterial infection. The presence of discharge, redness, and irritation in both eyes makes conjunctivitis a likely diagnosis.
- Other Likely Diagnoses
- Blepharitis: Inflammation of the eyelids can cause purulent discharge, especially if there is an associated infection. This condition often involves both eyes and can be chronic.
- Dry Eye Syndrome: Although less likely to cause purulent discharge, severe dry eye can lead to secondary infections, which might present with discharge.
- Allergic Conjunctivitis: While typically causing more itching and tearing than purulent discharge, severe allergic reactions can lead to secondary infections.
- Do Not Miss Diagnoses
- Gonococcal Conjunctivitis: A rare but serious cause of purulent discharge, especially in newborns (as a result of maternal transmission during birth) or in adults with a history of sexually transmitted infections. It requires prompt treatment to prevent complications.
- Chlamydial Conjunctivitis: Similar to gonococcal conjunctivitis, chlamydial infections can cause purulent discharge and are particularly concerning in newborns and immunocompromised individuals.
- Endophthalmitis: Although typically presenting unilaterally, in rare cases, endophthalmitis (infection within the eye) can cause bilateral symptoms, including purulent discharge, and is a medical emergency.
- Rare Diagnoses
- Dacryocystitis: Infection of the lacrimal sac can cause purulent discharge, especially if there is an obstruction of the nasolacrimal duct. This condition is less common and usually involves one eye but can be bilateral in rare instances.
- Canaliculitis: Infection of the canaliculi (small ducts that drain tears from the eye into the lacrimal sac) can cause purulent discharge and is often associated with Actinomycetes or other bacteria. It is a rare condition and typically unilateral but can be bilateral.