The diagnosis of infectious conjunctivitis rests primarily on the clinical examination. A Gram stain, which should be performed in neonates or in confusing cases, usually shows more than five white blood cells per oil immersion field and, in many cases, bacteria. The finding of gram-negative intracellular diplococci presumptively identifies N. gonorrhoeae in the first few weeks of life. Conjunctival scrapings and/or cultures may be performed in selected circumstances to diagnose C. trachomatis or specific viral and bacterial pathogens.
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