Midwifery National Practice Exam

The presence of thick purulent green discharge in a neonate, particularly appearing within 1-4 days of life, is highly indicative of a conjunctival infection due to Neisseria gonorrhoeae, commonly known as gonorrhea. This organism can be transmitted from an infected mother to the infant during delivery, potentially resulting in a serious eye infection known as gonococcal conjunctivitis.

This condition is characterized by heavy, purulent, and often greenish discharge, which is a significant clinical clue. If left untreated, gonococcal conjunctivitis can lead to severe complications, including corneal damage and even blindness, making prompt recognition and treatment critical in affected infants.

Chlamydia can also cause conjunctivitis in neonates, but it typically presents later, around 5-14 days after birth, and the discharge is more often watery than purulent. Sticky eye, which refers to a more non-specific condition usually linked to blocked tear ducts, would not typically present with such thick discharge nor is it a pathogenic infection. Thrush, on the other hand, is a fungal infection that primarily affects the oral cavity and is not associated with conjunctival discharge.