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OD2 - Applied Clinical Training & Research Studies in Vision and Optometry > MIIM - Bacteria and Fungi Causing Ocular Infections IV - Week 3 > Flashcards

MIIM - Bacteria and Fungi Causing Ocular Infections IV - Week 3 Flashcards

1
Q

What gram stain, shape, and metabolic state is moraxella?

A

Gram negative diplococci

Strict aerobe

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2
Q

Is moraxella oxidase and catalase positive or negative?

A

Positive for both

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3
Q

Name the two major moraxella pathogens, and two conditions each they can cause.

A

Moraxella lacunata

  • conjunctivitis
  • keratitis

Moraxella catarrhalis

  • acute conjunctivitis
  • opportunistic infection (like endophthalmitis)
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4
Q

Name 2 means of pathogenesis for moraxella.

A

Fimbriae mediate attachment

Lipopolysaccharides in the cell wall induces inflammation

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5
Q

Name a source for each of the two major moraxella bacteria.

A

Moraxella catarrhalis - normal component of respiratory and ocular flora
Moraxella lacunata - also found as a commensal

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6
Q

What is the ideal specimen for a suspected case of moraxella?

A

Discharge swab

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7
Q

What antibiotics is moraxella resistant to (explain why), and what is the management for an infection?

A

Most isolates produce β-lactamase, and is resistant to penecillin and amoxycillin.
Amoxycillin-clavulanate or oral cephalosporins are used.
Susceptibility test beforehand is ideal.

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8
Q

What gram stain, shape, and metabolic state are neisseria bacteria?

A

Gram negative diplococci

Aerobic

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9
Q

Name the two major neisseria bacteria, and the systemic diseases they cause (3).

A

Neisseria meningitidis - meningiococcal disease
-meningitis and septicaemia
Neisseria gonnorhoeae - gonorrhoea

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10
Q

How is gonorrhoea transmitted?

A

Sexually

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11
Q

Are neisseria bacteria able to survive easily outside the body or are they fastidious?

A

They are fastidious

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12
Q

Name two ocular diseases caused by neisseria gonorrhoea.

A

Adult conjunctivitis

Ophthalmia neonatorum

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13
Q

What can prolonged untreated conjunctivitis lead to?

A

Keratitis

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14
Q

Name 4 ways ophthalmia neonatorum can be prevented.

A

Screening pregnant women from high risk populations
-antibiotic treatment for those infected

Prophylactic treatment of newborns with ophthalmic ointments like tetracyclines or erythromycin - raises resistance concerns

Silver nitrate eye drops used at birth to prevent gonococcal eye infection

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15
Q

Name one way chemical conjunctivitis can be induced?

A

Siver nitrate drops to prevent gonococcal eye infection

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16
Q

Name 6 means of pathogenesis in neisseria.

A
  • Able to penetrate the corneal epithelium without pre-existing defects
  • Fimbriae attachement
  • Variation in fimbrial proteins to counteract immune response
  • Outer membrane proteins mediate invasion and survival in phagocytes
  • Cell wall components, especially lipo-oligosaccharides, cause inflammation
  • IgA protease
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17
Q

Name a source of neisseria. Is it a part of the normal microbiota?

A

It spreads from contacts with gonorrhoea (sexually or poor hygiene).
It is not part of the normal microbiota.

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18
Q

What two ideal specimen for a neisseria lab diagnosis? Elaborate.

A

A conunctival swab or corneal scraping. Must be transported quickly to the lab in an appropriate transport medium as it is fastidious.

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19
Q

Is neisseria pyogenic?

A

Yes

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20
Q

How can neisseria be cultured?

A

Using a culture of pus or scrapings on enriched media.

Antibiotics may sometimes be added to surpress the normal microbiota.

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21
Q

Is neisseria oxidase positive?

A

Yes

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22
Q

Name 4 ways neisseria infections can be managed.

A
  • Penicillin course
  • Resistance is common in urban areas - susceptibility tests are essential
  • Empirical treatment depends on source of infection
  • Treating associated STI essential
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23
Q

Name three ways neisseria infections can be prevented.

A

Health education
Good hygiene
Effective diagnosis and treatment

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24
Q

What bacteria is responsible for the most common STI?

A

Chlamydia trachomatis

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25
Q

Does chlamydia trachomatis have a lipopolysaccharide membrane and peptidoglycan layer?

A

Has an outer lipopolysaccharide layer, but no peptidoglycan

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26
Q

Describe the gram stain of chalmydia trachomatis. Elaborate on what is seen on a slide.

A

Technically it is gram negative, but is not seen in a stain, because of its size.

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27
Q

Briefly describe the life cycle of chlamydiae (7).

A
  • Elementary bodies attach by adhesins into mucosal epithelia.
  • EBs are endocytosed into inclusion, and doesnt fuse with a lysosome.
  • EBs transform into metabolically active reticulate bodies.
  • In cells with multiple inclusions, they fuse to form one.
  • Reticulate bodies multiply.
  • Reticulate bodies mature back into infectious EBs or persist in the cell as an aberrant body.
  • Newly matured EBs are released to infect other cells.
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28
Q

What two diseases can chlamydia trachomatis cause, and what serovars?

A

Serovars A-C - trachoma

Serovars D-K - inclusion conjunctivitis

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29
Q

What chlamydia bacteria is associated with follicular conjunctivitis?

A

Chlamydophila psittaci - causes psittacosis, associated with follicular conjunctivitis

30
Q

What is the most common cause of preventable blindness worldwide?

A

Trachoma

31
Q

What conditions is trachoma most common in (5)?

A 
Hot
Dry
Dusty
Scarce water
Poor sanitation
32
Q

Describe the progression of trachoma blindness beginning with repeated infection of the conjunctiva (9).

A
  • Repeated infection of the conjunctiva
  • Lymphoid follicles and inflammatory infiltration
  • Eyelid scarring
  • Trichiasis
  • Entropion
  • Corneal abrasion
  • Scarring
  • Blindness
33
Q

Name three structures that are damaged with trichoma progression.

A

Goblet cell, lacrimal gland, and tear duct destruction.

34
Q

What lid defect does trachoma cause?

A

Defects in lid closure like trachiasis.

35
Q

Describe trachiasis.

A

Eyelashes are misdirected, and grow inwards towards the eye, rubbing on the cornea, conjunctiva, and inner lid surface, causing irritation.

36
Q

Describe entropion. Which eyelid does it usually affect, and which one is affected in trachoma?

A

It is the turning in of the edge of an eyelid, usually seen on the lower eyelid, but both are affected in trachoma. It causes the lashes and lid edge to rub against the eye.

37
Q

Briefly describe the lifecycle of chlamydiae (3).

A

Flies carry the bacteria onto eyes when feeding on discharge.
Bacteria infects and spreads through direct contact.
Flies breeding in human faeces spread the disease to others.

38
Q

Briefly describe how trachoma causes blindness (3).

A

The infection inflames and thickens the upper eyelid.
The scarred eyelids turn inwards and rubs against the cornea.
The lashes scratching the cornea continually leads to blindness.

39
Q

Name four symptoms of inclusion conjunctivitis in adults.

A

Scanty mucopurulent discharge
Epithelial keratitis
Marginal and central infiltrates

40
Q

Does corneal scarring and neovascularisation occur in inclusion conjunctivitis?

A

Yes

41
Q

Does inclusion conjunctivitis involve one or both eyes?

A

In adults, usually just one eye.

42
Q

What appearance does the lower eyelid have with inclusion conjunctivitis, and what are these structures?

A

The eyes are red, and the lower eyelid has many small red bumps, which are lymphoid follicles.
This is called collicular conjunctivitis.

43
Q

In most cases, how does adult inclusion conjunctivitis spread? Name three additional ways.

A 
Mostly caused due to the eye being exposed to infected genital secretions 
( ͡° ͜ʖ ͡°) 
Water in swimming pools
Contaminated hot tubs
Sharing makeup
44
Q

Name 4 symptoms of neonatal inclusion conjunctivitis.

A

Eyelid oedema
Hyperaemia
Conjunctival infiltration
Discharge

45
Q

If untreated, what does neonatal inclusion conjunctivitis lead to?

A

Blenorrhoea, which is excess mucus

46
Q

In what population of babies is neonatal inclusion conjunctivitis seen in?

A

Babies born vaginally to an asymptomatic (but infected) mother

47
Q

When does neonatal inclusion conjunctivitis present afterbirth?

A

5-19 days afterbirth

48
Q

Name three means of pathogenesis in chlamydiae.

A

Adhesins allowing colonisation of columnar epithelium
Evasion of host immune responses by forming inclusions
Inhibits apoptosis

49
Q

Define tropism.

A

Specificity towards a particular tissue

50
Q

What two specimens are ideal for a suspected chlamydia infection for lab diagnosis?

A

Conjunctival discharge or corneal scraping.

51
Q

What is seen on a gram stain of chlamydia (4)?

A

Lymphocytes
Monocytes
Macrophages
Chlamydiais not seen

52
Q

What is seen on a giemsa stain of chlamydia?

A

Intracytoplasmic inclusions

53
Q

Name 2 detection methods for chlamydia.

A

Antigen detection by enzyme immunoassay - EIA

Nucleic acid detection by PCR

54
Q

Name 3 means of management for chlamydia infection.

A

Long term antibiotic treatment due to antibiotics.
Personal hygiene
Contact tracing of STI

55
Q

What syndrome is C. trachomatis serovars D-K infection associated with?

A

Reiter’s syndrome

56
Q

What is syphilis caused by?

A

The spirochaete - treponema pallidum

57
Q

When left untreated, name the three stages of syphilis.

A

Primary - painless chancre at the inoculation site
Secondary - skin rashes, other organ involvement including ocular complications
Tertiary - cardiovascular involvement and neurosyphilis

58
Q

Describe a chancre.

A

Fluid filled ulcer

59
Q

How can a definitive diagnosis for syphilis be made?

A

Lab diagnosis via a serology for antibody response.

60
Q

What percentage of those with syphilis will usually have ocular complications, and what is the most common complication?

A

10%, most commonly being uveitis.

61
Q

Which antibiotic is used to treat syphilis? Is resistance a problem?

A

Penicillin is used, which it typically doesnt resist. Reinfection can occur.

62
Q

Name 5 ocular conditions that can be caused by syphilis.

A 
Keratitis
Keratoconjunctivitis
Orbital cellulitis
Endophthalmitis
Uveitis
63
Q

Describe keratitis.

A

Inflammation of the cornea.

64
Q

Describe two causes of non-infectious keratitis.

A

Minor injury or wearing contact lenses too long.

65
Q

Is infectious keratitis an emergency?

A

Yes, urgent referral is essential.

66
Q

List 7 symptoms keratitis.

A 
Red eye
Eye discomfort
Photophobia
Blurred or decreased vision
Pain
Vision loss
Pus
67
Q

Name three risk factors of keratitis associated with contact lens wear.

A

Wearing them too long
Poor disinfection
Wearing them while swimming

68
Q

List 4 risk factors for keratitis (aside from those associated with contact lenses).

A

Reduced immunity (including corticosteroid use)
Warm climate
Previous eye injury
Recent corneal disease

69
Q

Name 5 bacteria that can cause keratitis.

A 
Staphylococcus aureus
Streptococcus pneumoniae
Pseudomonas aureginosa
Enterobacteriaceae
Moraxella
70
Q

Name three non-bacterial agents that can cause keratitis.

A

Fungi
Parasites (like acanthomoeba)
Viruses

OD2 - Applied Clinical Training & Research Studies in Vision and Optometry (174 decks)

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