Microbiology Flashcards
Name 4 types of conjunctivitis
Bacterial
Viral
Chlamydial
Allergic
Bacterial conjunctivitis - clinical features
Red eye Lots of pus Sticky discharge Gritty sensation Vision is unaffected
Bacterial conjunctivitis - unilateral or bilateral
Starts unilateral and becomes bilateral
Bacterial conjunctivitis - papillae or follicles
Papillae
Bacterial conjunctivitis - investigations
Local anaesthetic then take swab from tissue inside fornix
Bacterial conjunctivitis - management
Self limiting but topical antibiotics clear it faster
Bacterial conjunctivitis - example of topical antibiotics used (and side effects)
Chloramphenical
- patient may develop worsening of symptoms with this treatment. If this occurs then the patient may be allergic to it.
Bacterial conjunctivitis - what does chloramphenicol not treat
Pseudomonas aeruuginosa (treat with gentamicin)
Chlamydial conjunctivitis - clinical features
Chronic history
Red eye
Painless
May have symptoms of urethritis, vaginitis
Chlamydial conjunctivitis - Definition
Chronic unilateral follicular conjunctivitis
Chlamydial conjunctivitis - examination
Follicles - looks like rice grains
Chlamydial conjunctivitis - management
Usually unresponsive
Topical oxytetracycline
Viral conjunctivitis - clinical features
Watery eyes
Pink eyes
Bottom eyelid is affected
Viral conjunctivitis - examination
Red velvety appearance of conjunctiva
Follicles (look like rice grains on conjunctiva)
Viral conjunctivitis - causes
Adenovirus
Herpes simplex
Herpes zoster
Keratitis
Inflammation of the cornea
Bacterial keratitis - clinical features
Painful eye
Red eye around limbus
Reduced vision
Hypopyon
Bacterial keratitis - examination
Abnormal corneal reflection
Bacterial keratitis - investigations
Corneal scrape
Bacterial keratitis - management
Hourly drops (day and night) Ofloxacin Gentamicin and Cefuroxime (if ofloxacin doesn't work)
Hypopyon
Fluid level of pus in the anterior chamber
Viral keratitis - example
Herpetic keratitis which causes dendritic ulcer
Viral keratitis - clinical features
Very painful Red eye around limbus Recurrent - every time pt gets an episode the pain lessens due to reduced corneal sensation Profuse lacrimation Vision may be reduced
Viral keratitis - dendritic ulcer
Located in the cornea
It is white and thin
Has many branches like a tree
Viral keratitis - investigations
Fluroscene dye and then shine blue light
Viral keratitis - management
Antivirals eg zovirax (aciclovir)
Viral keratitis - which medication do you NOT use and why?
Steroids
- this can result in a geographical ulcer which can burst causing perforation of the cornea
Adenovirus keratitis - cause
Usually occurs after a URTI
Adenovirus keratitis - clinical features
Small white sub-epithelial infiltrates on the cornea
Bilateral
Adenovirus keratitis - management
Self limiting
May give topical antibiotics to prevent secondary infection
Fungal keratitis - clinical features
Chronic history
Not really sore
Autoimmune keratitis - clinical features
Loss of the peripheral aspect of the cornea
Endopathlmitis - definition
Infection of the inside of the eye
Affects the entire globe
Endopthalmitis - causative organisms
Often commensals - e.g. staph epidermidis
Endopthalmitis - clinical features
Very painful
Decreasing vision
Very red eye
Endopthalmitis - investigations
Culture of aqueous humour or vitreous body
Endopthalmitis - management
Inject antibiotics into the eye
- amikacin, vancomycin
Orbital cellulitis - definition
Infection which affects the skin around the eye
Orbital cellulitis - cause
Post sinus surgery
sinus infection
laceration to the eye
Orbital cellulitis - clinical features
Redness to the rim of the orbit Collection of pus within orbit Painful during eye movements Swollen, tender eyelid Proptosis Fever Mucous dripping out of nose
Orbital cellulitis - investigations
CT scan
Orbital celulitis - management
Broad spectrum antibiotics
Toxoplasma gondii - which type of infection?
Protozoan
Toxoplasma gondii - cause
Cats
Raw meat
Toxoplasma gondii - examination
Brown area of the retina
White fluffy area of retina is the reactivated organism
Toxoplasma gondii - complications
Reactivation
Toxacara - which type of infection?
Parasitic
Toxacara - cause
Cats, Dogs
Toxacara - complications
Formation of granulomas causes irreversible visual loss
Dacrocystitis - definition
Due to blockage of the lacrimal canniculi
