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PubMed1993

[Ocular symptoms in Wegener's granulomatosis--personal observations].

The authors present 10 patients treated for Wegener's granulomatosis. In 5 of of them (50%) the ocular changes were observed: in 3-infiltration of the orbit, including one case with infiltration of lacrimal ducts, and in 2-the recurrent bacterial conjunctivitis. On the account of the rareness of the disease and its various symptoms, the diagnosis, in some cases, was made fairly late. It was emphasized that the ocular lesions may be the first symptoms of Wegener's granulomatosis. The bacterial conjunctivitis, keratitis, scleritis, and orbital pseudotumor in patients with chronic respiratory tract and nasal sinuses changes should arouse suspicion of Wegener's granulomatosis and are an indication for detailed tests.

Adult↗
PubMed1998

Tear IgE concentrations in allergic conjunctivitis.

PURPOSE: Tear IgE has been considered to play an important role in allergic conjunctivitis and the measurement of tear IgE concentrations can help to diagnose this condition. Locally produced IgE levels have been shown to be the largest contributor to the severity of allergic conjunctivitis. METHODS: One hundred and thirteen allergic conjunctivitis patients (70 seasonal allergic conjunctivitis (SAC), 21 perennial allergic conjunctivitis (PAC), 22 vernal keratoconjunctivitis (VKC)), 14 bacterial conjunctivitis (BC) patients, 13 epidemic keratoconjunctivitis (EKC) patients and 18 normal controls were recruited. Tear samples were collected using the microcapillary method and tear IgE levels were measured using an immunoenzyme assay. RESULTS: Tear IgE concentrations showed significant increases in the VKC (322.2 +/- 45.7 ng/ml), SAC (194.7 +/- 21.7 ng/ml) and PAC (134.8 +/- 23.1 ng/ml) groups when compared with controls (52.1 +/- 9.7 ng/ml, p < 0.01). No significant difference was found between EKC (97.2 +/- 11.7 ng/ml) and BC (92.6 +/- 13.8 ng/ml) groups and controls (p = 0.1). CONCLUSIONS: Tear IgE concentrations showed a significant increase in allergic conjunctivitis patients when compared with controls. Our results suggest that measuring tear IgE concentrations can help to diagnose allergic conjunctivitis.

Adult↗
PubMed1992

Penicillinase-producing Neisseria gonorrhoeae conjunctivitis on some Nigerian children.

During 21 month study of bacterial conjunctivitis among 121 children in two health care centres in Calabar, Nigeria, a total of 90 (74.4%) cases were culturally confirmed. Neonates had the highest age-specific attack rates with 48 (53.3%) cases. Neisseria gonorrhoeae, the predominant pathogen, was recovered from 32 (35.6%) infections; 21 (65.6%) of them from neonates. Cultures of genital swabs of consenting parents of infected neonates as well as those of three female children aged 2-12 years with concurrent vulvo-vaginitis yielded N. gonorrhoeae. Younger women, mostly primi-gravidae were more frequently found to have benefited from peri-natal health care services than older multi-gravidae. Nevertheless, such access to health care services did not appear to influence the frequency of gonococcal conjunctivitis in neonates from the two maternal groups (P < 0.01). Sexual abuse and contaminated fomites were the possible modes of gonococcal infection transmission to older children. Overall, 22 (68.8%) strains of gonococci were resistant to penicillin; 19 (59.4%) were penicillinase-producing Neisseria gonorrhoeae (PPNG), while 5 (15.6%) had chromosomally-mediated resistance. All isolates were sensitive to erythromycin. This study recommends a review of gonorrhoea surveillance in pregnancy to include routine examination of cervical swabs just before delivery.

Adolescent↗
PubMed2002

Penetration of topically administered ofloxacin and trimethoprim into aqueous humor.

Ocular penetration of two topical antibiotics used to treat bacterial conjunctivitis was assessed in adult volunteers scheduled for cataract surgery. In this randomized, parallel-group study, patients instilled trimethoprim sulfate 0.1%/polymyxin B (n = 23) or ofloxacin 0.3% (n = 25) QID for 3 days, plus 4 instillations in the hour before surgery. Analysis of aqueous humor samples obtained during surgery showed a 2.4-fold greater concentration of ofloxacin over trimethoprim (1.135 micro g/ml vs 0.470 micro g/ml; P <.0001). The greater concentration of ofloxacin in ocular tissue coupled with its superior antibacterial activity profile supports its use as an alternative to trimethoprim/polymyxin B for treatment of bacterial conjunctivitis.

Adult↗
PubMed2003

Primary meningococcal conjunctivitis.

Neisseria meningitidis is an uncommon cause of acute bacterial conjunctivitis. One case of primary meningococcal conjunctivitis in a healthy 6-year-old boy is reported. The patient was initially treated with a topical instillation of polymyxin B, neomycin and gramicidin in ophthalmic solution, and this was followed by systemic rifampin once the diagnosis had been established. No ocular or systemic complications developed.

Administration, Oral↗
PubMed2006

Ocular complications of atopic dermatitis in children.

Ocular complications of atopic dermatitis in adults are blepharitis, keratoconjunctivitis, keratoconus, uveitis, subcapsular cataract and retinal detachment. Their frequency varies from 25% to 50%. The aim of this study was to assess the frequency and type of ophthalmological complications in children with atopic dermatitis. The secondary objectives of the study were to determine whether there is a correlation between severity of atopic dermatitis, face involvement, external ocular signs and the presence of ocular complications, and to identify risk factors for ophthalmological complications. Thirty-seven boys and 22 girls, mean age 36.2 months, with atopic dermatitis were examined. Atopic dermatitis severity was mild according to the SCORAD index (31.6 +/- 17.0). Fifteen (25.4%) children had external ocular signs, one had a nuclear cataract, 11 had benign papillofollicular conjunctivitis, one had purulent bacterial conjunctivitis, one had chronic atopic blepharitis and one had amblyopia. Severity of atopic dermatitis, face involvement, and external ocular signs did not seem to influence the incidence of ocular involvement. This study suggests that severe ocular complications are rare in young children with mild atopic dermatitis.

Adolescent↗
PubMed2004

An outbreak of conjunctivitis due to a novel unencapsulated Streptococcus pneumoniae among military trainees.

BACKGROUND: Bacterial conjunctivitis usually occurs as sporadic cases; outbreaks are uncommon and usually are associated with school campuses. We report an outbreak of Streptococcus pneumoniae conjunctivitis at a military training facility. METHODS: An outbreak investigation was done. Each case of conjunctivitis was evaluated with an assessment tool including demographic and clinical data. Conjunctival swabs were obtained. Pneumococci underwent standard testing, including serotyping with the Quellung reaction, capsular staining, and multilocus sequence typing. Sequence types were compared with previous reported outbreak strains by construction of dendrograms. Carriage rates of S. pneumoniae were determined among previously undiagnosed case patients with conjunctivitis, and a case-control study was performed. Control measures included education to increase hand washing, distribution of alcohol-based hand gel, and prompt treatment of patients with conjunctivitis. RESULTS: During a 6-week period, 92 cases of conjunctivitis occurred among 3500 persons, with an attack rate of 1.75 cases per 100 person-months. Eighty cases (87%) were due to S. pneumoniae; 45 (49%) were confirmed, and 35 (38%) were probable. Ten percent of recruits surveyed carried the outbreak strain. Twenty-two percent self-reported symptoms consistent with conjunctivitis during the outbreak period; sharing washcloths was associated with conjunctivitis (odds ratio, 11.7; P=.03). The causative organism was resistant to azithromycin but susceptible to telithromycin. The outbreak strain was an unencapsulated S. pneumoniae that has not been previously described; it was most closely related to the sequence type causing the Dartmouth College (Hanover, NH) outbreak of conjunctivitis in 2002. CONCLUSIONS: We report a conjunctivitis outbreak among military trainees caused by a novel, unencapsulated strain of S. pneumoniae.

Adolescent↗
PubMedDate not supplied

Primary meningococcal conjunctivitis: report of 21 patients and review.

Neisseria meningitidis is an uncommon cause of acute bacterial conjunctivitis. Twenty-one cases of primary meningococcal conjunctivitis (PMC) are reported herein and 63 cases published in the literature since 1899 are reviewed. In the 84 cases of PMC available for analysis, the male-to-female ratio was 1.76:1; nine of the patients were neonates, 55 were children, and 20 were adults. Conjunctivitis was unilateral in 66.3% of the patients. Gram stain of conjunctival exudate disclosed gram-negative diplococci in all cases in which it was done. Culture of the conjunctival exudate yielded N. meningitidis in all cases, and 44% of the isolated meningococci belonged to serogroup B. Ocular complications, which occurred in 15.5% of the patients, most frequently were corneal ulcers. Systemic meningococcal disease developed in 17.8% of the patients; the overall mortality was 13.3% for patients with PMC complicated by systemic disease. Development of systemic disease was significantly more frequent in patients receiving only topical therapy than in those treated with systemic therapy (31.71% vs. 2.38%; P = .001). Gram-negative diplococci observed in conjunctival exudate are an indication for systemic antibiotic therapy because of the risk of systemic complications associated with the use of topical therapy alone. When properly treated, patients with PMC have a favorable prognosis.

Child, Preschool↗
PubMed1985

[Determination of resistance and antibiotic therapy in bacterial eye diseases of childhood].

From June 1982 to December 1983 children aged between 3 days and 5 years (average 2-1/2 years) with bacterial conjunctivitis, blennorrhea or perforated corneal ulcers were examined microbiologically. The results of 30 antibiotic susceptibility tests were compared with those of adults. Prevalence of Escherichia coli (6%) and Staphylococcus aureus haemolyticus (17%) was observed; Candida species was not found in the young children. Pediatric diseases revealed themselves to be more pronounced in general. The authors diagnosed 3 chlamydial blennorrheas in newborn aged 7, 8 and 10 days. Mixed infections were found significantly less often in children (21%) than in adults (64%). The authors point out the need for epidemiologic antibiotic susceptibility studies to facilitate decision making for ad hoc therapeutic measures that are sometimes indicated in endophthalmitis or severe blennorrhea. The possible complications of antibiotic polypragmasia and the use of fixed combinations are discussed.

Anti-Bacterial Agents↗
PubMed1998

[Lomefloxacin in treatment of infectious eye diseases].

The data on the use of the difluoroquinolone lomefloxacin in the treatment of ocular infections such as bacterial conjunctivitis and keratitis, ulcer of the cornea, uveitis, gonococcal and chlamydial conjunctivitis are presented.

Adolescent↗
PubMed1987

Diagnosis of ophthalmia neonatorum.

Ninety consecutively seen babies with eye discharge in the first three weeks of life were examined. Four babies had "sticky eyes" with no evidence of ophthalmia and had uniformly negative cultures and test results for antichlamydial antibody; these babies were excluded. Of the 86 babies with ophthalmia neonatorum, Neisseria gonorrhoeae was isolated from eight, Chlamydia trachomatis from 44, other bacteria alone from 20, and 14 had negative cultures. Three babies with negative cultures had longstanding conjunctivitis and had been treated with chloramphenicol eye ointment; all had antichlamydial IgM antibodies, indicating that the conjunctivitis was chlamydial. Hence the total number of babies whose conjunctivitis was chlamydial was 47. The result of the Gram stained conjunctival smear correlated well with that of culture and final assessment by the microimmunofluorescence test, enabling an immediate presumptive diagnosis to be made of gonococcal, chlamydial, or bacterial conjunctivitis. Prompt and effective treatment of babies was started. Explanation to the mother and contact tracing were carried out when the confirmatory cultures and antibody tests were completed. The Gram stained conjunctival smear is a highly sensitive, specific, and predictive test for the aetiological agent of ophthalmia neonatorum. By virtue of its simplicity and rapidity the test may be useful in developing countries.

Antibodies, Bacterial↗
PubMed1987

Fucithalmic in acute conjunctivitis. Open, randomized comparison of fusidic acid, chloramphenicol and framycetin eye drops.

Fucithalmic, which is 1% fusidic acid in a sustained-release eye preparation, was shown to be superior to both chloramphenicol eye drops and framycetin (Soframycin) eye drops in the treatment of bacterial conjunctivitis in Tanzania. The clinical success rate was 77/83 (93%) on fusidic acid compared with 22/46 (48% on chloramphenicol and 26/35 (74%) on framycetin (P less than or equal to 0.02). The better effect of fusidic acid could be ascribed to a much lower rate of in vitro resistance (17%) compared to chloramphenicol (58%) and framycetin (41%). Because of the low resistance rate to fusidic acid among eye pathogens, especially in areas of the world with a high resistance towards other commonly used eye anti-infectives, Fucithalmic given twice daily would seem to be a valuable new eye anti-infective.

Acute Disease↗
PubMed1992

Fucithalmic, chloramphenicol or no treatment after squint surgery in children. A single blind randomised study.

One hundred and four children undergoing strabismus surgery were randomised post-operatively to one of three treatment groups; 1) fucithalmic drops twice daily; 2) chloramphenicol (chlormycetin) ointment twice daily; 3) no treatment. Allocation to the 'no treatment' group had to be stopped after 3 of the first 8 patients in the group developed severe mucopurulent conjunctivitis. A parental questionnaire and clinical assessment, carried out in a single blind fashion revealed that nearly all parents were able to apply the prescribed treatment and that both treatments were effective in preventing bacterial conjunctivitis. Post-operative antibiotics seem to be necessary following squint surgery in children, and fucithalmic viscous drops are a useful alternative to chlormycetin ointment.

Adolescent↗
PubMed1987

Relation of the outcome of conjunctivitis and the conjunctivitis-otitis syndrome to identifiable risk factors and oral antimicrobial therapy.

The epidemiology, microbiology and clinical outcome of the conjunctivitis-otitis syndrome (CJ-AOM) was investigated in a rural private practice concurrent to a double blind placebo-controlled study of orally administered amoxicillin for prevention of acute otitis media (AOM) secondary to conjunctivitis. Bacterial pathogens were isolated when greater than 15 polymorphonuclear leukocytes/high power field were observed on Gram-stained smear of conjunctival secretions. Nontypable Haemophilus influenzae biotype 2 predominated in CJ-AOM; however, Streptococcus pneumoniae was isolated nearly as frequently as H. influenzae in conjunctivitis without AOM. Younger age (P = 0.001) and more episodes of AOM in the previous year (P = 0.006) were risk factors for CJ-AOM. Persistence of AOM was frequently observed in CJ-AOM. The frequency of AOM secondary to conjunctivitis was reduced (P = .01) in amoxicillin recipients (2 of 41) compared with placebo (11 of 42), but amoxicillin failed to eradicate nasopharyngeal carriage of H. influenzae. More episodes of AOM per year (P less than 0.001) and day care (P less than 0.001) were found to be risk factors for AOM secondary to conjunctivitis.

Acute Disease↗
PubMed1992

The safety and efficacy of topical norfloxacin compared with chloramphenicol for the treatment of external ocular bacterial infections. The Norfloxacin-Chloramphenicol Ophthalmic Study Group.

Two hundred and forty-six patients with signs of acute bacterial conjunctivitis and/or blepharitis were randomised to receive either norfloxacin or chloramphenicol for one week in this double-masked parallel group study. Ninety-two per cent of the norfloxacin-treated patients and 93% of the chloramphenicol-treated patients were rated as either clinically improved or cured at the end of the treatment period. Based upon pre-treatment bacteriological cultures, 31.3% of the patients had significant bacterial infection of the lids and/or conjunctiva. All of these culture-positive patients were rated as either clinically improved or cured. Based upon post-treatment cultures, 72 of 82 strains of Gram-positive and Gram-negative bacteria were eradicated or suppressed following treatment with either norfloxacin or chloramphenicol. However six of 41 strains persisted for norfloxacin and four of 41 for chloramphenicol. Two norfloxacin-treated patients and three chloramphenicol-treated patients had adverse experiences, predominantly ocular discomfort, which required cessation of drug therapy. Norfloxacin appears to be an effective and relatively safe agent for the treatment of bacterial infections of the lids and/or conjunctiva. In this study, norfloxacin was clinically and microbiologically similar in activity to chloramphenicol.

Acute Disease↗
PubMedDate not supplied

[Isolation of Haemophilus aegyptius associated with Brazilian purpuric fever, of Chloropidae (Diptera) of the genera Hippelates and Liohippelates].

The recognition of the Brazilian purpuric fever (BPF) in 1984 led to a number of studies which showed a relation between this disease and conjunctivitis caused by Haemophilus aegyptius. The increase in cases of conjunctivitis in children associated with higher population density of eye gnats (Chloropidae: Hippelates) has been reported since last century. This phenomenon is related to the attraction that those flies show for the eyes, secretions and wounds, from where they feed on. Although there are evidences on the role of these flies in the mechanical transmission of seasonal bacterial conjunctivitis, the isolation of Haemophilus aegyptius from them in their natural habitat had not been demonstrated yet. In this study Haemophilus aegyptius associated to BPF was isolated from two pools of chloropids collected around the eyes of children with conjunctivitis which were identified as Liohippelates peruanus (Becker) and a new species Hippelates neoproboscideus.

Adolescent↗
PubMed2006

Recurrent staphylococcal conjunctivitis associated with facial impetigo contagiosa.

PURPOSE: To report the uncommon occurrence of impetigo contagiosa in the setting of recurrent staphylococcal conjunctivitis. DESIGN: Interventional case report. METHODS: A 32-year-old patient had a recurrent painful red left eye and facial rash. Clinical examination revealed left bacterial conjunctivitis and facial bullous impetigo. Microbiology cultures were taken from the nose, conjunctiva, and facial lesions. RESULTS: Microbiologic cultures grew Staphylococcus aureus, and hematology findings demonstrated an elevated white cell count with neutrophilia. Complete resolution was achieved with topical chloramphenicol ointment and oral dicloxacillin. CONCLUSIONS: Although uncommon, bullous impetigo may be associated with recurrent staphylococcal conjunctivitis in adults. Recurrent infections may require nasal decolonization, systemic antibiotics, and antiseptic body wash.

Administration, Oral↗