VIRAL CONJUNCTIVITIS

Question 1

what is adenoviral conjunctivitis?

Answer 1

it is caused by a group of adenovirus & can be divided into 3 sydnrome depending on the type of serotype involved.

Question 2

what are the 3 types of viral conjunctivits? and serotype?

Answer 2

1. acute non-specific follicular conjunctivitis - serotype 1-11.
2. pharyngo-conjunctival fever (PCF) - serotype 3-5 &7.
3. epidemic kerato-conjunctivitis (EKC) - serotype 8.

Question 3

what are the general symptoms of viral conjunctivitis?

Answer 3

• FBS/gritty
• tearing
• photophobia
• recent cold

Question 4

what are the general signs of viral conjunctivitis?

Answer 4

• Follicles (hallmark)
• Pseudo membranes
• Serous discharge – separates it from bacterial infx.
• Diffuse conjunctival hyperemia
• Follow systemic viral infection.

Question 5

what is the most common type of adenoviral conjunctivitis?

Answer 5

• acute non-specific follicular conjunctivitis

Question 6

specific signs for PCF?

Answer 6

• general signs for viral conjunctivitis
• fever
• pharyngitis (sore throat)

Question 7

specific signs for EKC?

Answer 7

• general signs for viral conjunctivitis
• keratitis (2wks)
• SEIs (3wks)

Question 8

which viral conjunctivitis is the most common in kids?

Answer 8

PCF

Question 9

what are the 2 most common modes of transmision for PCF?

Answer 9

• respiratory droplets
• swimming pool!

Question 10

which adenoviral conjunctivitis is the most severe?

Answer 10

EKC - b/c it involves the cornea (keratitis) making it painful.

Question 11

what are the stages of EKC?

Answer 11

Viral conjunctivitis stages (rule of 8s):
* 0-8 days – symptoms occur 8 days after exposure (conjunctivitis).
* 8-16 days – diffuse PEE (keratitis)
* 16 days – PEE resolves, SEI develop (pt no longer contagious

Question 12

the presence of SEI’s in EKC means ___?

Answer 12

pt is no longer contagious

Question 13

viral conjunctivitis can be contagious for up to ____ days?

Answer 13

14

Question 14

tx for adenoviral conjunctivitis?

Answer 14

• Self-limited – typically gets worse the first 4-7 days after onset and may not resolve for 2-3 weeks.
• Educated on contagious nature of the Dz (avoid exposures to others) + Rec pt clean bed sheets & towels.
• Cool compresses several times per day.
• If membrane/pseudo membrane present – gently peel
• If SEIs reduce vision – Rx mild-moderate topical steroid qid.
• F/U – in 2-3 wks

Question 15

what is molluscum contagiosum? what species is involved?

Answer 15

It is a viral infection caused by DNA poxvirus.

Question 16

what dz is multiple molluscum nodules associated with?

Answer 16

if >100 nodules consider consider human immunodeficiency virus (HIV) or other immunodeficiency conditions.

Question 17

who gets molluscum contagiosum?

Answer 17

those with poor hygiene

Question 18

symptoms of molluscum contagiosum?

Answer 18

• Asymptomatic but may have mild discharge.

Question 19

signs of molluscum contagiosum?

Answer 19

• Single or multiple pale, dome-shape, waxy umbilicated nodules located on the lid or lid margin.
• Rupture of the molluscum nodules –> leads to chronic follicular conjunctivitis (toxic) and superficial pannus.

Question 20

tx for molluscum contagiosum?

Answer 20

• nodules – remove via excision, curettage, or cryotherapy.
• refer to HIV testing (western blot & ELISA).
• F/U – every 2-4 weeks until conjunctivitis resolves.