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Phlyctenular Keratoconjunctivitis


Presentation

  • The presentation is usually bilateral. The diagnosis can be difficult, especially if compounded by an underlying skin disorder such as rosacea.[ncbi.nlm.nih.gov]
  • CASE REPORT A 22-year-old man presented with painful, bilateral, elevated vascularized corneal lesions.[unboundmedicine.com]
Cervical Lymphadenopathy
  • These children may suffer from enlarged tonsils, adenoids and cervical lymphadenopathy. Various aetiological factors which contribute to development of PKC are: Bacteria: Mycobacterium tuberculosis. Staphylococcus aureus. Propionibacterium acnes.[genericdrugscan.com]
Peripheral Neuropathy
  • Oral metronidazole has also been proposed as a treatment for ocular rosacea, but while it seems to be an effective treatment, the fact that short-course therapy is required in order to avoid peripheral neuropathy may result in more frequent relapses [[joii-journal.springeropen.com]

Workup

  • The workup in 10 of these patients included chlamydial cultures and/or monoclonal immunofluorescent antibody stain of conjunctival smears for Chlamydia antigen. Five of these patients (50%) had at least one positive test for Chlamydia.[entokey.com]
Entamoeba Histolytica
  • Entamoeba histolytica. Fungi: Candida albicans. Coccidioides immitis. Human leukocyte antigen (HLA) subtypes: A26. B35. DR8. Meibomitis: Phlectenular keratitis may be associated with meibomitis ( Suzuki T, Mitsushi Y, Yoichiro S, et al.[genericdrugscan.com]
Coccidioides Immitis
  • Coccidioides immitis. Human leukocyte antigen (HLA) subtypes: A26. B35. DR8. Meibomitis: Phlectenular keratitis may be associated with meibomitis ( Suzuki T, Mitsushi Y, Yoichiro S, et al.[genericdrugscan.com]

Treatment

  • We believe oral tetracycline is a safe and effective treatment for resistant and recurrent nontuberculous phlyctenular keratoconjunctivitis and an alternative to topical corticosteroid treatment in those patients suffering from corticosteroid-induced[ncbi.nlm.nih.gov]
  • Culbertson WW, Huang AJW, Mandelbaum SH, et al: Effective treatment of phlyctenular keratoconjunctivitis with oral tetracycline. Ophthalmology 100:1358, 1993 22.[oculist.net]
  • A three-day treatment (1 drop bid) was initially prescribed every 10 days (i.e., three treatments monthly) for at least 1 month. According to clinical efficacy, treatment was tapered to one treatment every 15 days and then one treatment monthly.[joii-journal.springeropen.com]
  • If positive, appropriate systemic treatment of these infections is required as well as screening and possible treatment of close contacts.[eyewiki.aao.org]
  • Palliative Treatment Lid hygeine regimen Artificial tears for comfort Pharmacologic Treatment: Topical Medications Steroids in the presence of conjunctival involvement (i.e.[decisionmakerplus.net]

Prognosis

  • On the basis of this report, penetrating keratoplasty for corneal scarring due to PKC seems to have a favorable prognosis.[ncbi.nlm.nih.gov]
  • Prognosis: Phlyctenular conjunctivitis often has mild symptoms and many patients may be asymptomatic. Disease limited to the conjunctiva is self-limiting and usually resolves within two weeks without leaving any scar.[genericdrugscan.com]
  • The prognosis is good, but the disease can recur through the years. Chlamydial Conjunctivitis It is characterized by follicular hyperplasia and mucopurulent discharge. It is often conjoined with cervicitis and urethritis.[optometry-today.com]

Etiology

  • Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology.[icd10coded.com]
  • Thygeson P: Etiology and treatment of phlyctenular keratoconjunctivitis. Am J Ophthalmol 34:1217, 1951 5. Rohatgi J, Dhaliwal U: Phlyctenular eye disease: a reappraisal. Jpn J Ophthalmol 44:46–150, 2000 6.[oculist.net]
  • To determine the clinical characteristics, possible etiologic agents, and response to oral antibiotic therapy in patients with phlyctenular keratoconjunctivitis.[ncbi.nlm.nih.gov]
  • Phlyctenular keratoconjunctivits is also called phlyctenulosis and other possible etiologies include tuberculosis and Chlamydia.[decisionmakerplus.net]
  • The underlying infectious etiology requires further investigation when the possibility of tuberculosis or chlamydia is suspected.[eyewiki.aao.org]

Epidemiology

  • Epidemiologic characteristics. Am Rev Respir Dis 91:171, 1965 8. Sorsby A: The aetiology of phlyctenular ophthalmia. Br J Ophthalmol 26:159, 189, 1942 9. Fritz MH, Thygeson P, Durham DG: Phlyctenular keratoconjunctivitis among Alaskan natives.[oculist.net]
  • Diagnosis: Phlyctenular keratoconjunctivitis EPIDEMIOLOGY Predominantly young individuals SIGNS Staphylococcal blepharitis Inflammation of cornea or conjunctiva Wedge-shaped nodular lesion and engorged hyperemic vessels at or near the limbus, bulbar conjunctiva[webeye.ophth.uiowa.edu]
  • EPIDEMIOLOGIC CHARACTERISTICS. ( 14253167 ) PHILIP RN...SHELTON JH 1965 33 PHLYCTENULAR KERATOCONJUNCTIVITIS AMONG ESKIMOS IN SOUTHWESTERN ALASKA. II.[malacards.org]
  • Epidemiology Conjunctivitis is the most common eye disease. [29] History An adenovirus was first isolated by Rowe et al. in 1953.[isnare.com]
  • Epidemiology of Allergic Conjunctivitis. Curr Opin Allergy Clin Immunol. 2011 Oct 11 (5): 471-476. DOI: 10.1097/ACI. 0b013e32834a9676 [cited 2017 Jan 5]. Available from: . Shoji J, Inada N, Sawa M.[bjain.com]
Sex distribution
Age distribution

Pathophysiology

  • PATHOPHYSIOLOGIC CONSIDERATIONS There is some debate about the pathophysiology and causes of phlyctenular keratoconjunctivitis.[entokey.com]

Prevention

  • If patients have seborrheic blepharitis, eyelid scrubs may help prevent recurrence. Click here for Patient Education NOTE: This is the Professional Version.[merckmanuals.com]
  • By means of concise text supported by a wealth of color illustrations the authors' aim is to enable the reader to reach a fast and accurate diagnosis, to ensure early treatment which may ultimately prevent the occurrence of further disease.[books.google.com]
  • M.D.C MDC Category Not Assigned For This ICD Code H16.25 Medicare Severity-Diagnosis Related Groups MS-DRG MS-DRG Category Not Assigned For This ICD Code H16.25 Clinical Classifications Software CCS CCS Category Not Assigned For This ICD Code H16.25 Prevention[medicbind.com]
  • What they found adds to... [ Read Full Story ] May 10, 2019 If your provider is ordering nebulizers and the drugs used in them for their patients here are things in the documentation that will help prevent a resubmission to Medicare and ease medical coding[coder.aapc.com]

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