Microbiology Flashcards
bacterial conjuncitivits presents as
pus
red
crusty
painful
What is the cause of bacterial conjunctivitis in neonates
chlamydia
gonorrhoea
staph aureus
(from coming out of the birth canal)
What is the cause of bacterial conjunctivitis in adults
staph aureus
H. influenza
strep pneumonia
What is the investigation for bacterial conjunctivitis
swab for culture with local anaesthetic before
What is the treatment for bacterial conjunctivitis
topical Abx - chloramphenicol QD
- fusidic acid if allergic
What does viral conjunctivitis present as
red
watery
painful
What is the causes of viral conjunctivitis
adenovirus - most common, usually from an URTI
HSV
HZV
What sign is usually present in viral conjunctivitis caused by HZV
hutchinson’s sign
What is Hutchinson’s sign
tip of the nose involvement, shows nasociliary nerve involvement
What is the investigation for viral conjunctivitis
viral swab - not always needed
What is the treatment for viral conjunctivitis
adeno and HSV = self limiting
HZV - aciclovir (within 72hrs)
What does chlamydial conjunctivitis present as
chronic
bilateral red eye that doesn’t respond to treatment
follicles (rice grains) on undersurface of upper eyelid
scarring of undersurface of eyelid
may also have urethritis/vaginitis
What is the investigation for chlamydial conjunctivitis
contact tracing
What is the treatment for chlamydial conjunctivitis
topical oxytetracycline
What does bacterial keratitis present as
v painful
red
may have hypopyon
What is bacterial keratitis associated with
contact lens wearers
corneal damage Hx
dry eyes
What is a hypopyon
white cell infiltrates present in the anterior chamber that leaves a white meniscus
What is the cause of bacterial keratitis
staph aureus
acanthamoeba/pseudomonas in contact lens wearers
What is the investigation for bacterial keratitis
corneal scrape
acanthamoeba - microscopy/culture
What is the treatment for bacterial keratitis
admission for hourly drops
ofloxacin
if resistant - gentamicin and cefuroxime
What is the cause of herpetic keratitis
HSV
What is the major complication of herpetic keratitis
dendritic ulcer
How is a dendritic ulcer seen
on immunofluorescence with a blue light
What is the treatment for herpetic keratitis
aciclovir
What must not be given in herpetic keratitis
steroids
this will cause thinning of the cornea if there is a dendritic ulcer and cause the cornea to burst
What is the cause of adenoviral keratitis
adenovirus usually from URTI
What is the presentation of adenoviral keratitis
bilateral
contagious
What is the treatment for adenoviral keratitis
can get abx prophylaxis to prevent secondary infection
steroids may speed up recovery
Orbital cellulitis is caused by
extension from a paranasal infection most commonly
extension from a facial orbital infection
post-op
What does orbital cellulitis present as
v painful
swollen
proptosis if severe
pyrexia
What is a major complication of orbital cellulitis
compartment syndrome - compresses the nerve and causes loss of vision
what is the investigation for orbital cellulitis
CT
What is the treatment for orbital cellulitis
v broad spectrum Abx
cover - coliform, staph, strep, anaerobes, H. influenza
may need drainage
What is endophthalmitis
inflammation of the entire globe
What is the cause of endophthalmitis
surgery/endogenous
staph epidermidis usually
What is the presentation of endophthalmitis
v painful v red reduced vision sudden onset sight threatening
What is the investigation for endophthalmitis
aqueous humour/vitreous humour for culture
What is the treatment for endophthalmitis
amakacin/vancomycin + topical abx
What is chorioretinitis
inflammation at the back of the eye
What is the cause of chorioretinitis
CMV in AIDs toxoplasma gondii (protozoa from cats) toxoplasma canis (worm from cats/dogs)
What is the investigation for toxoplasma gondii and toxoplasma canis
serology
What is the cause of dacrocystitis
blockage of the lacrimal canaliculi causes a build up of lacrimal fluid which leads to infection
What is the treatment for dacrocystitis
penicillin
