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PHMP LEC 211 > MICROBIAL DISEASES OF THE EYES AND SKIN > Flashcards

MICROBIAL DISEASES OF THE EYES AND SKIN Flashcards

1
Q

The Etiological agents that may affect the eyes will
vary depending on the ______ of tissue
affected

A

area and type

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2
Q

Disease spread may be divided into:

A

➔ Eyelids and tissue surrounding the eyes
➔ Conjunctiva
➔ Cornea
➔ Intraocular area

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3
Q

BLEPHARITIS
● Etiological agent are

A

Demodex folliculorum (a mite)

Followed by bacterial infection Staphylococcus aureus
or Staphylococcus epidermidis

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4
Q

Diagnosis : Due to an allergic reaction to the mite
which resides in the eyelash or the eyebrow

A

BLEPHARITIS

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5
Q

Abscesses
may form in and around the follicles, destroying the
follicles, with the loss of lashes and the formation of
ulcers.

A

BLEPHARITIS

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6
Q

BLEPHARITIS
Treatment:

A

Glucocorticoid
Doxycycline or Minocycline
Azithromycin

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7
Q

Glucocorticoid-______

A

for the allergic reaction

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8
Q

There may be a history of itching and scaling
of the lid since early childhood. The patient
describes an incessant urge to pull on the
lashes in an attempt to remove the scales

A

BLEPHARITIS

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9
Q

HORDEOLUM AND CHALAZION
● Etiological agents are generally

A

Staphylococcus
aureus, but may also be caused by Pseudomonas
aeruginosa and Proteus spp.

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10
Q

Diagnosis: Obstruction of the orifice of a gland
(_____,_____,____) seems to be the primary
pathological event in the formation of hordeolum (______)

A

HORDEOLUM AND CHALAZION

Meibomian, Zeis, or Moll

Stye

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11
Q

A red nodule that is quite painful develops and is
surmounted with a yellowish top as the lesion matures.

A

HORDEOLUM AND CHALAZION

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12
Q

HORDEOLUM AND CHALAZION
The histopathology is typical of

A

acute suppurative
inflammation

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13
Q

(untreated stye) evolved from
hordeolum that do not drain spontaneously or
are not incised.

A

Chalazion

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14
Q

HORDEOLUM AND CHALAZION

There is usually persistent chronic
inflammation, and ______ may
occur as sebaceous secretions are impounded.

A

granuloma formation

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15
Q

HORDEOLUM AND CHALAZION
Treatment:

A

Erythromycin
Cefalexin
Doxycycline

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16
Q

Treatment

for susceptible strains and for
prevention of corneal and conjunctival
infections

A

Erythromycin:

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17
Q

may be added if there recurrent
lesions or significant meibomitis

A

Doxycycline:

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18
Q

PERIORBITAL CELLULITIS
● Etiological agent are

A

Staphylococcus aureus (most
common), S. pneumoniae, H. influenzae

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19
Q

PERIORBITAL CELLULITIS
Also known as

A

periseptal cellulitis

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20
Q

PERIORBITAL CELLULITIS
Diagnosis: Characterized by

A

acute eyelid erythema
and edema

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21
Q

PERIORBITAL CELLULITIS
Treatment

A

Clindamycin as empirical therapy
Doxycycline, cotrimoxazole

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22
Q

ACUTE DACROCYSTITIS
● Etiological agent are

A

Staphylococcus aureus,
Staphylococcus epidermidis and Streptococcus
Pneumoniae

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23
Q

Diagnosis:
➔ This is an infection of the lacrimal sac,
almost always secondary to obstruction of the
lacrimal duct.

A

ACUTE DACROCYSTITIS

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24
Q

Occurs when both the upper and lower ends of
the drainage system become partially or totally
obstructed. The major symptom is pain in the
tear sac area. There are also erythema,
edema, a purulent discharge and epiphora

A

ACUTE DACROCYSTITIS

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25
Q

ACUTE DACROCYSTITIS
Treatment

A

➔ Coamoxiclav, Sultamicillin (sulbactam +
ampicillin) , Levofloxacin (fluoroquinolone)
➔ Tobramycin ophthalmic
➔ Tobramycin plus dexamethasone
ophthalmic (too much inflammation)

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26
Q

are immunosuppressants which suppresses the
immune action like inflammation, redness and swelling.

A

Glucocorticoids

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27
Q

CHRONIC DACROCYSITITIS
● Etiological agents are

A

Streptococcus pneumoniae,
Haemophilus influenzae, Candida albicans ,Aspergillus sp., Actinomyces sp.

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28
Q

is usually caused by a single
site of partial or complete obstruction within the
lacrimal sac or within the nasolacrimal duct. The
infection is usually the result, and not the cause, of
obstruction

A

CHRONIC DACROCYSITITIS

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29
Q

CHRONIC DACROCYSITITIS
Obstruction may be due to:

A

➔ Trauma
➔ Tumors
➔ Foreign bodies
➔ Delayed canalization in neonates
➔ Closure of canal in postmenopausal women

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30
Q

(Sore eyes)

A

PINK EYE CONJUNCTIVITIS

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31
Q

PINK EYE CONJUNCTIVITIS (Sore eyes)
● Etiological agent are

A

Haemophilus aegypticus and/or
Moraxella lacunata

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32
Q

Diagnosis: The only symptoms are conjunctivitis,
either chronic or acute, and severe inflammation of the
cornea. Diagnosis is via isolation of the organism (
Gam-negative slender rod).

A

PINK EYE CONJUNCTIVITIS (Sore eyes)

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33
Q

PINK EYE CONJUNCTIVITIS (Sore eyes)
Treatment

A

➔Topical sulfacetamide, erythromycin,
ciprofloxacin or ofloxacin.
➔ NEW agent: besifloxacin: Opthalmic
suspension

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34
Q

Ocular Lymphogranuloma Venereum
● Etiological agent:

A

Chlamydia trachomatis

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35
Q

Diagnosis:
➔ This is a chlamydial disease transmitted to
the fetus during passage down the birth
canal (vertical transmission)

A

Ocular Lymphogranuloma Venereum

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36
Q

Inflammation begins about five days after
birth and never results in follicle formation
(thus, it differs from trachoma and inclusion
conjunctivitis).

A

Ocular Lymphogranuloma Venereum

37
Q

Corneal scars, conjunctival scars, and
micropannus formation occur.

A

Ocular Lymphogranuloma Venereum

38
Q

It is rarely a cause of blindness.

A

Ocular Lymphogranuloma Venereum

39
Q

Ocular Lymphogranuloma Venereum
Treatment

A

Azithromycin, Erythromycin, Doxycycline
(DOC) but caution in children

40
Q

Trachoma
● Caused by

A

Chlamydia trachomatis

41
Q

This disease is limited to man, infecting only epithelial
cells of the eye and possibly the nasopharynx; no
systemic involvement has been described. It is found
worldwide, and is the greatest single cause of blindness.

A

Trachoma

42
Q

Scarring of the conjunctiva may cause the eyelids to
turn inward so that the lashes scratch the cornea

A

Trachoma

43
Q

Pink, smooth, thin and transparent. Over the whole
area of the tarsal conjunctiva, there are large deeplying
blood vessels that run vertically

A

Normal Tarsal Conjunctiva

44
Q

Presence of five or more follicles in the upper tarsal
conjunctiva
➔ Follicles are round swellings that are paler
than the surrounding conjunctiva, appearing
white, grey or yellow
➔ 0.5 mm in diameter

A

(TF)Trachomatous Inammation- follicular

45
Q

Pronounced inflammatory thickening of the tarsal
conjunctiva that obscures more than half of the normal
deep tarsal vessels in
➔ The tarsal conjunctiva appears red, rough and
thickened, with numerous follicles which
may be covered by the thickened conjunctiva

A

(TI)Trachomatous Inammation-Intense

46
Q

● Scars are visible as white lines or sheets in the tarsal
conjunctiva. They are glistening and fibrous in
appearance.

A

Trachomatous scarring (TS)

47
Q

_____especially diffuse fibrosis, may obscure the
tarsal blood vessels

A

Scarring,

48
Q

● At least one eyelash rubs on the eyeball
● Evidence of recent removal of inturned eyelash

A

Trachomatous Trichiasis (TT)

49
Q

The pupil margin is blurred viewed through the
opacity. Such corneal opacities cause significant visual
impairment ( less than 6/18 or 0.3 vision) and visual
acuity should also be measured

A

corneal opacity

50
Q

Trachoma Treatment

A

● DOC for trachoma: Azithromycin
● Alternative: 1% tetracycline ointment

51
Q

VIRAL CONJUNCTIVITIS
● Etiological agents are

A

-Adenovirus types 3,7 and 8,
-Human Herpesvirus 1 (Herpes simplex 1 virus) ,
-Human Herpesvirus 2 (Herpes simplex 2 virus),
-Varicella-Zoster virus and
-Cytomegalovirus

52
Q

Diagnosis: Bilateral conjunctivitis which is usually self
limited. No
constitutional symptoms are present

A

VIRAL CONJUNCTIVITIS

53
Q

VIRAL CONJUNCTIVITIS
Treatment:

A

➔ Artificial tears
➔ Azalastine ophthalmic
Ketotifen

54
Q

Relatively selective H1 receptor antagonist that
inhibits the release of mast cell

A

Ketotifen

55
Q

caused by a virus, like the
common cold. This type of pink eye is very
contagious, but usually will clear up on its own
within several days without medical treatment .

A

Viral conjunctivitis

56
Q

Caused by eye irritants
such as pollen, dust and animal dander among
susceptible individuals. Allergic conjunctivitis may be
seasonal (pollen) or flare up year-round (dust; pet
dander)

A

Allergic Conjunctivitis -

57
Q

caused by bacteria, this
type of conjunctivitis can cause serious damage to
the eye it left untreated

A

Bacterial conjunctivitis

58
Q

VIRAL CONJUNCTIVITIS
● Etiological agents are

A

Candida albicans, Sporothrix
schenkii, Allescheria sp., Aspergillus sp., Mucor sp

59
Q

Diagnosis: An uncommon disease which can be acute
or chronic. Often secondary to fungal infections of
other parts of the body. Often aggravated by
glucosteroids and initiated after antibiotic therapy.
Diagnosed by isolation of the etiological agent

A

VIRAL CONJUNCTIVITIS

60
Q

VIRAL CONJUNCTIVITIS
Treatment

A

➔ Natamycin: Initial drug for fusarium disease
➔ Amphotericin B: First agent of choice for
corneal infections due to yeast such as
candida
➔ Azoles: For Fusarium, Aspergillus,
Curvilaria and Candida
➔ Flucytosine: Active against Candida and
Cryptococcus
➔ Voriconazole: DOC for aspergillus, Fusarium
Blastomyces, Coccidiodes, Curvularia and
other fungal infection - azole that inhibits the
conversion of lanosterol to ergosterol

61
Q

PARASITIC CONJUNCTIVITIS:

A

Onchocerciasis
African eye worm

62
Q

River blindness

A

(Onchocerca vulvulus)

63
Q

Onchocerciasis: transmitted by

A

simulium
blackflies

64
Q

Second leading cause of blindness in the world

A

Onchocerciasis

65
Q

Onchocerciasis
Treatment

A

Ivermectin
Moxidectin
Doxycycline

66
Q

a macrolytic lactone for 12 yrs and
older, does not kill adult O. vulvulus

A

Moxidectin

67
Q

may be used to eliminate the
endosybiotic bacteria Woblachia;
this disrupts production of
microfilariae by the adult female worm

A

Doxycycline

68
Q

African eye worm

A

LOA LOA

69
Q

LOA LOA
Transmitted by

A

Chrysops deer fly

70
Q

LOA LOA
● Treatment:

A

Diethylcarbamazine
Albendazole

71
Q

Serves as inhibitor of arachidonic
acid metabolism in microfilaria

Available only through CDC

A

Diethylcarbamazine

72
Q

For treatment of symptomatic
loiasis with parasitemia of 8000
microfilariae/mL

A

Albendazole

73
Q

OPHTHALMIA NEONATORUM
● Etiological agent is

A

Neisseria gonorrhoeae

74
Q

Diagnosis: The disease is contracted from a mother
with gonorrhea as the fetus passes down the birth
canal. Infection does not occur in utero. At one time
about 10% of all cases of blindness in the United States
was due to this disease.

A

OPHTHALMIA NEONATORUM

75
Q

OPHTHALMIA NEONATORUM
major clinical sign

A

Corneal inflammation

76
Q

OPHTHALMIA NEONATORUM
Treatment

A

➔ Erythromycin oral or ointment
★ Systemic treatment is necessary
➔ Silver nitrate drops ( rarely used now)
★ May be used to prevent disease

77
Q

Inflammation of the cornea

A

BACTERIA KERATITIS

78
Q

➔ Rapid progression
➔ Corneal destruction may occur in 24-48 hours
(blindness)

A

BACTERIA KERATITIS

79
Q

BACTERIA KERATITIS
Features:

A

Corneal ulceration, stromal abscess
formation, surrounding corneal edema and
anterior segment inflammation

80
Q

BACTERIA KERATITIS
Etiological agents:

A

Streptococcus, Pseudomonas,
Enterobacteriaceae ( Klebsiella, Enterobacter,
Serratia and Proteus), Staphylococcus

81
Q

BACTERIA KERATITIS
Treatment

A

➔ Tobramycin (14 mg/mL)
★ 1 drop every hour, alternating with
fortified cefazolin or vancomycin.
➔ Fourth-Generation Fluoroquinolones
★ Moxifloxacin and Gatifloxacin :
Penetrates better than Gati
➔ New Fluoroquinolone : Besifloxacin
★ Approved in 2009 for bacterial
conjunctivitis.

82
Q

_____ species is the most common isolate in
fungal keratitis world wide, followed by _____ and
_____

A

Aspergillus

Fusarium

penicillium

83
Q

● More common in men than in women
● May be acquired through unhygienic contact lens use
● This may extend from the cornea to the sclera and
intraocular structures

A

FUNGAL KERATITIS

84
Q

FUNGAL KERATITIS
May cause

A

scleritis, endopthlamitis, panopthalmitis

85
Q

Very difficult to treat and may result to visual loss and
loss of eye

A

FUNGAL KERATITIS

86
Q

FUNGAL KERATITIS
Treatment

A

Ampothericin B
Natamycin

87
Q

Common causes of Anterior uveitis

A

➔ Mumps virus, Human Herpesvirus 3
(Varicella-Zoster virus), Rubella virus,
Rubeola virus, Human Herpesvirus 1
(Herpes simplex 1 virus)

88
Q

Common causes of Posterior uveitis:

A

➔ Toxoplasma gondii (25% of all cases)
Toxocara sp., Cryptococcus neoformans,
Histoplasma capsulatum, Mycobacterium
tuberculosis, Cytomegalovirus, Herpessimplex 1 virus, Human immunodeficiency
virus

PHMP LEC 211 (15 decks)

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