Microbiology Flashcards

1
Q

conjunctivitis

A

conjunctiva is red and inflamed

acuity, pupillary responses and corneal lustre are unaffected

eyes itch, burn and lacrimate

there may be photophobia

often bilateral with lids sticking together

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2
Q

papillae conjunctivitis

A

red dots of varying size

allergic and bacterial

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3
Q

follicular conjunctivitis

A
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4
Q

course of conjunctivitis

A

usually self-limiting

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5
Q

what should you consider in prolonged conjunctivitis - especially in YP or those with sexual disease

A

chlamydial conjunctivitis

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6
Q

common organisms of bacterial conjunctivitis in neonates

A
  • Staph. aureus*
  • Neisseria gonorrhoea*
  • Chlamydia trachomatis*
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7
Q

common organisms for bacterial conjunctivitis in all other ages

A
  • Staph. aureus*
  • Strep, pneumoniae*
  • H. influenzae* (especially in children)
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8
Q

what can allergic conjunctivitis be treated with

A

anti histamine drops

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9
Q

how does the discharge of bacterial conjunctivitis differ from viral etc

A

more purulent and eye more red

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10
Q

what is the first line treatment for bacterial conjunctivitis

A

swab of eye and treat with topical ABx, usualyl chloramphenicol

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11
Q

2nd and 3rd line treatment for bacterial conjunctivitis

A

2 - fusidic acid (S. Aureus)

3 - gentamicin (Gram-negatives, severe but good)

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12
Q

what organism does chloramphenicol not treat

A

Pseudomonas aeruginosa

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13
Q

when should chloramphenicol be avoided

A

anaplastic anaemia (possible association) or allergy

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14
Q

describe the defining features of viral conjunctivitis

A

more pink than bacterial

there is no green/yellow pus, more of a thick watery secretion

there is often a history of URTI, and pre-oricular and submandibular lymph nodes often are enlarged

very contagious

red velvety appearance of conjunctiva and raised follicles

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15
Q

what is the most common cause of viral conjunctivitis

A

Adenovirus

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16
Q

adenovirus conjunctivitis

A

often follows URTI

small lymphoid aggregates appears as follicles on conjunctiva

17
Q

HSV conjunctivitis

A

usually a manifestation of primary infection

treated with acyclovir (analogue of guanosine)

18
Q

ophthalmic shingles

A

can present with purulent conjunctivitis etc

pain and neuralgia in the distribution of CNV1 dermatome precedes blistering rash

Hutchison’s sign may be present - tip of nose from nasociliary branch

19
Q

chlamydial conjunctivitis history

A

unresponsive to treatments

chronic and may last for months

20
Q

who usually gets chalmydial conjunctivitis

A

more common in newborns

also young adults

21
Q

symptoms of chlamydial conjunctivitis

A

unilateral conjunctivitis (less commonly bilateral)

chronic history

there may be symptoms of urethritis and vaginitis

22
Q

describe the eye in chlamydial conjunctivitis

A

it is a chronic follicular conjunctivitis

the follicles are described as being like rice grains, can lead to subtarsal scarring

23
Q

treatment of chlamydial conjunctivitis

A

topical oxytetracycline

oral azithromycin may also be needed for genital chlamydial infection

24
Q

keratitis

A

Corneal inflammation, identified by a white area on the cornea indicating a collection of white cells.

25
hypopyon
a collection of inflammatory cells seen in the anterior chamber, also called sterile pus
26
treatment of bacterial keratitis
hourly drops of a 4-quinolone eg **ofloxacin** (doesnt treat *S. Pneumoniae)* also gentamicin and cefuroxim
27
HSV keratitis
classical **dendritic ulcer** as this is where the infection is very painful and may be recurrent DO NOT treat with steroids - **acyclovir**
28
adenovirus keratitis
bilateral and usually follows UTI contagious may affect vision small white flecks are seen - subepithelial infiltrates
29
fungal keratitis
usually seen in contact lense wearers common organisms are: acanthamoeba and pseudomonas aeruginosa there is typically more of a chronic indolent history, often with note of trauma from vegetation less of a red eye is seen
30
orbital cellulitis
inflammation of the eye tissues behind the orbital septum, sight threatening it is important to distinguish from pre-septal cellulitis as this is not that severe
31
typical patient with orbital cellulitis
Typically children with lid swelling, fever, orbital inflammation, and decreased eye mobility
32
what other clinical features are often present in orbital cellulitis
infection is often spread from paranasal sinus infection - there will be mucous coming out the nose check the ears and pupils in children
33
organisms commonly causing orbital cellulitis
* Staphylococci * Streptococci * Coliforms * H. influenzae * Anaerobes
34
investigation and treatment of orbital cellulitis
CT scan to identify orbital abscesses broad spectrum ABx and monitor closely abscess may require drainage
35
what is the most common organism causing endophthalmitis
Staph epidermidis
36
endophthalmitis
devastating infection of entire globe of eye very painful and associated with decreased vision, can be sight threatening