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Bacterial Conjunctivitis

Mucopurulent Conjunctivitis


Presentation

  • . 1 Neonates: Gonococcal conjunctivitis: presents 2-4 days following birth.[emdocs.net]
  • When 3 of the 4 predictors were present, the probability of the child having a negative culture was high. When all 4 predictors were present, the probability was greater than 90%.[jamanetwork.com]
  • […] in bacterial conjunctivitis, but mild in most cases; severe eyelid edema in the presence of copious purulent discharge raises the suspicion of N gonorrhoeae infection See Clinical Presentation for more detail.[emedicine.medscape.com]
  • Bacterial conjunctivitis was present in about one third (32.47% to 36.04%) of the patients with acute infective conjunctivitis, and it was more common in children.[nepjol.info]
  • KEY POINTS Viral conjunctivitis typically presents as an itchy red eye with mild watery discharge.[mdedge.com]
Disability
  • Indirect costs are defined as the value of economic output lost because of illness, injury-related work disability, or premature death [ 20 – 23 ].[bmcophthalmol.biomedcentral.com]
Preauricular Adenopathy
  • Acute bacterial conjunctivitis tends to differ from viral conjunctivitis by the presence of purulent discharge and the absence of chemosis and preauricular adenopathy.[msdmanuals.com]
Sputum
  • A cluster of 10 severe cases of nosocomial bacterial keratitis in three intensive care units showed almost identical bacterial growth in cultures from eye and sputum ( Hilton et al. 1983 ). All the patients had required frequent tracheal suctioning.[onlinelibrary.wiley.com]
Red Eye
  • KEY POINTS Viral conjunctivitis typically presents as an itchy red eye with mild watery discharge.[mdedge.com]
  • Patients with purulent discharge or a mild severity of red eye were found to benefit most from treatment with antibiotics Contact lens wearers with a diagnosis of bacterial conjunctivitis should be treated with a topical antibiotic effective against Gram[college-optometrists.org]
  • It is not normally serious, and is sometimes referred to as pink or red eye. There are three forms of conjunctivitis – bacterial, viral and allergic. This leaflet looks at bacterial and viral conjunctivitis.[aop.org.uk]
  • Differential diagnoses In patients with an acute red eye, the possibility of keratitis or iridocyclitis must always be considered.[onlinelibrary.wiley.com]
Foreign Body Sensation
  • Clinically, bacterial conjunctivitis is characterized by a purulent eye discharge, or sticky eyes on awakening, a foreign body sensation and conjunctival injection (pink eye). The diagnosis is made clinically. Cultures are unnecessary.[eurekaselect.com]
  • body sensation that prevents the patient from keeping the eye open Corneal opacity Fixed pupil Severe headache with nausea.[dermnetnz.org]
  • Variables showing an association of P Subanalyses of children above and below the cutoff age were performed to determine whether subjective factors (ie, eye itch, foreign body sensation, eye burning, eye pain, photophobia, and sore throat) had a greater[jamanetwork.com]
  • These conditions may cause eye pain, a feeling that something is stuck in your eye (foreign body sensation), blurred vision and light sensitivity. If you experience these symptoms, seek urgent care.[mayoclinic.org]
  • Symptoms can include redness of the conjunctiva, burning, frequent styes, foreign body sensation and morning eyelash crusting or eyelash loss. Another type of chronic conjunctivitis is meibomitis.[hopkinsmedicine.org]
Lacrimation
  • Also, an adjacent focus of infection, such as inflammation of the lacrimal gland (dacryocystitis), can cause recurrent or chronic conjunctivitis. 16[mdedge.com]
  • Symptoms are hyperemia, lacrimation, irritation, and discharge. Diagnosis is clinical. Treatment is with topical antibiotics, augmented by systemic antibiotics in more serious cases.[msdmanuals.com]
  • Allergic conjunctivitis is not associated with any discharge, but will be associated with increased bilateral lacrimation. Itching will predominate with eyes appearing more pink than red.[pharmaceutical-journal.com]
  • Factors predisposing for infection include ectropium and entropium, an obstructed nasolacrimal duct, abnormal lacrimal fluid and injured conjunctival epithelium following trauma, dry‐eye disease or previous infection ( Høvding 2004 ; Mannis & Plotnik[onlinelibrary.wiley.com]
  • […] no effect on the histamine that has already been released. 9 They may be used for prophylaxis and maintenance of mild-to-moderate symptoms. 4,9 MC stabilizers also provide relief of nasal symptoms because of drainage from the nasal passages into the lacrimal[uspharmacist.com]
Burning Eyes
  • Variables showing an association of P Subanalyses of children above and below the cutoff age were performed to determine whether subjective factors (ie, eye itch, foreign body sensation, eye burning, eye pain, photophobia, and sore throat) had a greater[jamanetwork.com]
  • More serious side effects include rash, itching or burning eyes, redness/ pain or swelling in or around the eyes, and vision problems.[rxlist.com]
  • Green or white discharge from the eye Itchy eyes Burning eyes Blurred vision More sensitive to light Swollen lymph nodes (often from a viral infection ) When to Call Your Doctor Make the call if: There’s a lot of yellow or green discharge from your eye[webmd.com]
Neglect
  • Identification of acute bacterial conjunctivitis Clinical features The clinical syndrome ranges from mild redness of the conjunctivae to corneal infiltration and visual disturbances in neglected cases. A purulent exudate is almost always present.[www2.health.vic.gov.au]

Workup

  • Types Viral conjunctivitis Epidemic keratoconjunctivitis Herpes zoster ophthalmicus Herpes simplex keratitis Bacterial conjunctivitis Gonorrheal conjunctivitis Chlamydia conjunctivitis Allergic conjunctivitis Caustic keratoconjunctivitis Evaluation Workup[wikem.org]
  • The cellular response in conjunctivitis differs according to the cause, as follows: Bacterial infections: Neutrophils predominate Viral infections: Lymphocytes predominate Allergic reactions: Eosinophils predominate See Workup for more detail.[emedicine.medscape.com]
Cytoplasmic Inclusion Bodies
  • Smears and conjunctival scrapings should be examined microscopically and stained with Gram stain to identify bacteria and stained with Giemsa stain to identify the characteristic epithelial cell basophilic cytoplasmic inclusion bodies of chlamydial conjunctivitis[msdmanuals.com]

Treatment

  • Cochereau I, Meddeb-Ouertani A, Khairallah M, et al. 3-Day treatment with azithromycin 1.5% eye drops versus 7-day treatment with tobramycin 0.3% for purulent bacterial conjunctivitis: multicentre, randomised and controlled trial in adults and children[ncbi.nlm.nih.gov]
  • : Antibiotics Treatment: Hygiene Seasonal Management Treatment for bacterial organisms is targeted toward S. aureus, S. pneumoniae, H. influenzae, Pseudomonas, N. gonorrhea, C. trachomatis Contact lens wearers should be given coverage for Pseudomonas[wikem.org]
  • Treatment should be given if the condition has not resolved spontaneously after 5 days Clean away infected secretions from eyes with cotton wool soaked in cooled boiled water Remove contact lenses until all symptoms have resolved and any treatment completed[ljf.scot.nhs.uk]
  • However, the benefits of antibiotics for the treatment of acute bacterial conjunctivitis have been questioned.[college-optometrists.org]
  • Treatment for bacterial conjunctivitis Mild cases of bacterial conjunctivitis often clear up within 1-2 weeks without special medical treatment.[ada.com]

Prognosis

  • Complications Acute bacterial conjunctivitis is almost invariably a disease with a highly favourable prognosis.[onlinelibrary.wiley.com]
  • Prognosis of viral conjunctivitis Viral conjunctivitis is extremely contagious and remains so for 14 days, which also is often how long the symptoms remain. The prognosis is very good for viral conjunctivitis.[intechopen.com]
  • Prognosis [ 11 ] Eyelid and conjunctival lesions tend to resolve over 1-2 weeks. Epithelial keratitis resolves over two weeks and has a good prognosis. Stromal keratitis is more likely to result in corneal scarring.[patient.info]

Etiology

  • Chlamydial conjunctivitis: most common etiology of infectious conjunctivitis in the newborn; occurs 1 week to 2 months following birth. 1 Chlamydial infection may cause concomitant pneumonia (staccato cough), otitis media, proctitis, and vulvovaginitis[emdocs.net]
  • Conjunctivitis, which is defined as inflammation of the bulbar and/or palpebral conjunctiva (the transparent lubricating mucous membrane that covers both the surface of the eye and lining of the undersurface of the eyelids), has many etiologies, including[emedicine.medscape.com]
  • Title: Bacterial Conjunctivitis in Childhood: Etiology, Clinical Manifestations, Diagnosis, and Management VOLUME: 12 ISSUE: 2 Author(s): Alexander K.C. Leung*, Kam L. Hon, Alex H.C. Wong and Andrew S.[eurekaselect.com]
  • Differentiating Features in Acute Conjunctivitis Etiology Discharge/Cell Type Eyelid Edema Node Involvement Itching Bacterial Purulent/polymorphonuclear leukocytes Moderate Usually none None Viral Clear/mononuclear cells Minimal Often present None Allergic[msdmanuals.com]
  • Etiology Acute bacterial conjunctivitis is primary due to Staphylococcus aureus, Streptococcus pneumoniae, and Haemophilus influenzae.[eyewiki.aao.org]

Epidemiology

  • Clinical Trial: www.clinicaltrials.gov NCT00357773 Keywords: conjunctivitis • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • antibiotics/antifungals/antiparasitics 2008, The Association for Research[iovs.arvojournals.org]
  • The epidemiology of acute bacterial conjunctivitis in Australia due to causes other than trachoma and gonococcal infection is not well documented. Infections are most common in children under five years of age, and incidence decreases with age.[www2.health.vic.gov.au]
  • Epidemiology Although the literature on the epidemiology of bacterial conjunctivitis contains several references to its highly contagious nature [ 7 – 10 ] no overall population-based data exists on the incidence of bacterial conjunctivitis.[bmcophthalmol.biomedcentral.com]
  • Epidemiology and diagnosis of acute conjunctivitis at an inner-city hospital. Ophthalmology 1989;96:1215–1220. [ PubMed ] [ Google Scholar ] 9. Woodland RM, Darougar S, Thaker U, et al.[ncbi.nlm.nih.gov]
  • Epidemiology [ edit ] Conjunctivitis is the most common eye disease. [35] Rates of disease is related to the underlying cause which varies by the age as well as the time of year.[en.wikipedia.org]
Sex distribution
Age distribution

Pathophysiology

  • Learning outcomes At the end of this case study, you will be able to: Outline the pathophysiology, signs and symptoms, and diagnosis of bacterial conjunctivitis; Describe the treatment options available for bacterial conjunctivitis; Outline the chemistry[pharmaceutical-journal.com]
  • Allergic conjunctivitis: update on pathophysiology and prospects for future treatment. J Allergy Clin Immunol. 2005;115:118-122. 8. Horton JC. Disorders of the eye. In: Fauci AS, Braunwald E, Kasper DL, et al, eds.[uspharmacist.com]

Prevention

  • Control measures for acute bacterial conjunctivitis Preventive measures Preventative measures include careful treatment of affected eyes and personal hygiene, particularly handwashing.[www2.health.vic.gov.au]
  • Prevention Prevention is important for avoiding the disease and stopping its spread. Careful washing of the hands, the use of clean handkerchiefs, and the avoidance of contagious individuals are all helpful.[ophthalmologyltd.com]
  • Therefore any significant benefit arising from the use of antibiotics in these studies appears to be related to the rate of resolution of the condition, rather than due to prevention of complications.[thennt.com]
  • Prevention of bacterial conjunctivitis While it may not always be possible to prevent bacterial conjunctivitis, taking the following steps can help to reduce the likelihood of an infection: Avoiding contact with people who have pink eye Maintaining good[ada.com]
  • Topical antibiotics shorten the course of the disease, reduce discomfort, prevent person-to-person transmission and reduce the rate of reinfection.[eurekaselect.com]

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