Eye Infections Flashcards
What leads to swelling of the eyelids?
Stye (Hordeola)
Inflammation of the conjunctiva is known as…
conjunctivitis
How is inflammation of the cornea called?
Keratitis
Inflammation of the cornea and the retina is called?
What is a chalazion?
It is a focal, chronic, lipogranulomatous inflammation of Zeis/meibomian glands
What is a hordelea/hordeleum?
Abscess forming infection of the eyelid that presents as a localized painful and erythematous swelling
A hordeolum involves what?
An infection of the glands of the eyelid that may be either internal or external. If the inflammation is due to a internal gland, the meibomian gland is probably responsible. If an external gland is inflamed, the gland of zeis or moll is involved
Chazalion involves what?
A sterile, chronic inflammation that results from a blocked meibomian gland
A chazalion infection may develop from?
An internal hordeleum
Which organism is heavily associated with hordeleum?
Staphylococcus aureus
Which other bacterium is involved in the formation of stye in some patients?
Propionibacterium acnes
P acnes is gram what?
Positive
What is the shape of P acnes?
Cocco bacillus (short rod)
P acnes can arrange how?
In chains or in clumps
Is P acnes motile?
No
Does P acnes form spores?
No
Is P acnes part of the normal flora?
Yes
Where can we find P acnes in the body?
Skin, conjunctiva, external ear, oropharnyx, female genital tract
What are some manifestations of the eyelid infections?
Acute, swollen, edematous, normal visual acuity, normal eye function, conjunctivitis, mucopurulent discharge, sensitivity, pustule
Which type of cancer may be misdiagnosed with recurrent or persistent hordeleas?
Basal cell carcinoma
What can cause an eye lid infection?
skin conditions, eye makeup, blockage, inflammation
Eye lid infections can be self limited? If so, how long do they take to go away?
1-2 weeks
What should a patient do as a home remedy to treat an eyelid infection?
Apply Warm compress for 10 minutes
If the external hordelia is big and causing the patient discomfort, what procedures can be done?
Lancing or epilating
What is the treatment for internal hordeleas?
A warm compress and also an antibiotic ointment such as nafcillin, oxacillin
If a patient presents with complications with cellulitis or has multiple / recurrent lesions, what antibiotic is considered?
Doxycycline
Inflammation of the conjunctiva can be…
Bulbar or palpebral meaning that if it’s bulbar the part of the conjunctiva that we can see convering the sclera is what is infected. The palpebral part of the conjunctiva is the one that folds that is going to start covering the eyelid on the inner side
What characteristic is found in conjunctivitis?
Pink eye
Conjunctivitis can be caused by what two agents?
Bacteria or viruses
Bacterial conjunctivitis is associated with what?
Otitis media
Viral conjunctivitis is associated with what?
Pharyngitis
Which two microorganisms are known to be a cause of bacterial conjunctivitis?
Haemophilus influenzae and streptococcus pneumoniae
Which virus is known to a cause of viral conjunctivitis?
Adenovirus
what other viral agents can cause conjunctivitis?
Enterovirus (infants and children)
What viruses can cause severe conjunctivitis?
Herpes simplex 1 and 2
Which bacteria can cause a severe case of conjunctivitis ?
Neisseria meningitidis
Which bacteria can cause vision loss in neonates?
Neisseria gonorrhea
Which bacteria can causes urethritis in adults?
Neisseria gonorrhea
Which bacteria can cause pneumonia in neonates?
Chlamydia trachomatis
Which other bacteria can cause disseminated urethritis in adults?
Chlamydia trachomatis
What are some manifestations of conjunctivitis?
Inflammation, blood vessel dilation (cause of pink eye), fullness, burning, grit, foreign body, excessive tearing
Bacterial conjunctivitis will cause…
purulent discharge
what other manifestations can be seen in conjunctivitis?
Petechial hemorrhages, lymphatic tissue hypertrophy, preauricular lymphadenopathy, photophobia
Neonates are susceptible to what condition during the first 10 days of life?
Opthalmia neonatorum
Can be caused by chlamydia/gonorrhea/HSV
Which class of chlamydial infection will lead to red itchy eyes and pues formation 5-10 days post birth
D-K
Which subtypes of chlamydia causes entropion?
A-C
Which other bacteria is also responsible for a red itchy eye with ours formation 5-10 days post birth?
Neisseria gonorrhea
Which bacteria is responsible for the sticky eye?
S aureus
Which virus causes a red, itchy eye with thin exudate and photophobia?
Adenovirus
For patients who suffer from conjunctivitis we should figure out if they…
Have any respiratory tract infections, have any sexually transmitted diseases, or have any fever blisters (cold sores)
Which agents are known to cause follicular conjunctivitis?
Adenovirus, chlamydia, HSV
The pathogens sis of conjunctivitis depends if the host has…
Defense alterations like an immmature immune system, a microbiota imbalance, or the bacterial species that they are exposed to
Can external contamination like not cleaning eye contact lenses lead to the development of conjunctivitis?
Yes
Can antibiotic use induce a microbiota imbalance and hence leading to a conjunctivitis?
yes
Can rubbing your eyes lead to a conjunctivitis?
Yes
What procedure should be performed if there is no improvement of the conjunctivitis after 58-72 hours?
Follicle scraping
what is the treatment for viral conjunctivitis?
Supportive care, artificial tears, cold compress, antibiotic drops (for secondary bacterial infection), corticosteroids (to manage the inflammation)
What is the treatment for bacterial infection?
Antibiotic drops
If the patient has a eye infection caused by gonorrhea, what antibiotics can be used?
Norfloxacin, cefoxitin, ceftriaxone,cefotaxime , spectinomycin
Which is the most common antibiotic used for an eye infection caused by gonorrhea?
Ceftriaxone 1g
which antibiotics should be considered if the eye infection is caused by a chlamydia bacteria?
Tetracycline
Doxycycline
Azithromycin
Erythromycin
What is keratitis?
Inflammation of the cornea fue to an infectious cause
With keratitis there is a risk of what?
Perforation which can lead to sight loss. This will depend on the aggressiveness of the etiológical agent
what are the most common bacterial causes of keratitis?
Staph aureus and pseudomonas aeruginosa
Which viral agents can be responsible for keratitis?
HSV-1, HSV-2, VZV, adenovirus
which is the most common fungi that is responsible for keratitis?
Candida albicans
Which other fungi can cause keratitis?
Hyphal fungi
Aspergillus
Fusarium
Which parasites cause keratitis?
Acanthamoeba and Hartmanella
What are some manifestations of keratitis?
Eye pain, vision impairment, photophobia, tearing, hypopyon
What are some manifestations of a keratitis infection due to strep pneumoniae?
Well defined ulcer, Sharp margins, grey base, hypopyon on early stage
What are the manifestations of a keratitis due to gonorrhea?
Rapid progression, perforation, newborns
What are the manifestations of a keratitis infection due to pseudomonas aeruginosa?
Most destructive, rapid spread, rapid perforation, severe pain, large hypopyon, green exudate, liquid infiltrate
What is a manifestation of a keratitis infection caused by the HSV-1/2 virus?
Branching dendritic ulcer
What are some manifestations of a keratitis infection due to the adenovirus?
Bilateral (both eyes are affected), the conjunctiva is also affected (bulbar and palpebral), subepithelial corneal infiltrates concentrated in central cornea
What what are some causes of a keraitirsjb abused by a fungal infection?
Trauma, organic matter contamination
Chronic use of glucocorticoids eye drops increases the chance of what?
Of someone acquiring a keratitis infection due to a fungus
In a fungal keratitis infection, we will have a..
Superficial and raised hypopyon
When viewing a keratitis infection caused by a fungus, what can we see?
satellite lesions, immune ring, irregular infiltrate
What is the most causitive agent of keratitis?
Bacterial infection then HSV
What are some risk factors that predispose someone to developing a keratitis?
Trauma, contact lenses, ocular surgery, diabetes, immuno suppression, defective tear production
How does a keratitis infection due to a bacteria look like?
Corneal opacity and/or infiltrate (round white spot), red eye, photophobia, foreign body sensation
What will the patient present if he/she has a keratitis infection due to HSV?
Red eyes, photophobia, foreign body sensation, watery discharge, branching grey opacity
The HAV virus tends to reactivate in the…
Ocular branch of the trigéminal nerve
Where is the HSV going to replicate in someone with keratitis?
The corneal epithelial cells
What can be observed in A-Prjmary infectious keratitis?
Vesicular eruption of the eyelid, infection of the cornea leading to corneal ulcers
Is recurrent herpes keratitis more common that primary keratitis?
Yes
Mild irritation and photophobia can be appreciated in?
Recurrent herpes keratitis
Patients with a keratitis caused by an adenovirus can experience what symptoms?
Photophobia and foreign body sensation
- multiple punctuate staining lesions can be seen and periauricular lymphadenopathy
Which serotypes are the most responsible for an adenovirus keratitis?
3 and 19
When the adenovirus infects the eye, there is initial infection of what?
Infection of conjunctiva which easily spreads bilaterally
How to diagnose a keratitis caused by a parasite?
Scrapings
Perform a calcoflour stain
How to diagnose a keratitis caused by a fungus?
Scrapings
Perform a gram stain
Diagnosis of a bacterial keratitis is based on?
Gram stain results
When should a doctor perform systemic treatment in a patient with bacterial keratitis?
If there is a case of perforation
What two antibiotics would you use to treat strep pneumoniae?
Bacitracin and Gentamicin
What two antibiotics would you use to treat staphylococcus aureus?
Cephalosporin and Bacitracin
What two antibiotics would you use to treat pseudomonas aeruginosa?
Tobramycin and gentamicin
What antibiotic would you choose to treat E.Coli, Klebsiella, and Proteus?
Gentamicin
What two antibiotics would you use to treat chlamydia trachomatis?
Doxycycline and erythromycin (neonates and infants)
is viral keratitis usually self limited?
Yes
What two antibiotics would you use to treat HSV
Acyclovir and trifluridine
What antiviral would you use to treat adenovirus?
Cidofovir
What antiviral would you use to treat varicella-zoster virus?
Famciclovir, acyclovir and valacyclovir
what two antifúngica la would you choose to treat candida albicans?
Amphotericin B and flucytosine
What antifungal would you choose to treat hyphal fungi?
Natamycin
what drugs would you use to treat acanthamoeba?
Neomycin and pentamidine isethionate
What microorganism can cause chorioretinitis?
Toxoplasma Gondi
Toxoplasma Gondi can be transmitted through what?
Cat feces and undercooked pork meat
The diagnosis of toxoplasmosis is based primarily on what?
The chorioretinal lesión rather than serological studies
If a neonate acquires toxoplasmosis it was probably a…
Utero infection
If an aids patient has a WBC count of less than 100 there I’ll be what type of spread in toxoplasma Gondi?
Hematogenous spread
What is the treatment for choriorenitis?
Prymethamine and sulfadiazine
Which is another causative agent responsible for chorioretinitis?
CMV virus
retinitis along a vascular distribution is a typical what?
CMV infection
In a patient with AIDS, if they acquire a cmv infection that leads to a chorioretinitis how would that look like?
Full-thickness retinal necrosis, edema, atrophic scar tissue, tearing, retinal detachment, no regenerations of retinal tissue, vision loss
In the biopsy for CMV, what characteristic can be seen?
Owls eye
Can CMV be found in a urine sample?
Yes
Can PCR help in the detection of CMV?
Yes
What can be used to clear the cmv infection in a patient with chorioretinitis?
Gangciclovir
