Chlamydial Conjunctivitis

Chlamydia are Gram-negative bacteria.

1 See Appendix for side effects of medications Lang, Ophthalmology © 2000 Thieme

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Table 4.2 Overview of infectious conjunctivitis

Cause

Clinical

Symptoms and

Pathogen

Treatment

course

findings

Bacteria

00 A

Bacteria

Staphylococcal Subacute Purulent discharge, conjunctivitis blepharitis, superficial punctate keratitis, thickening of the conjunctivitis at the lim-bus

Staphylococci: Gram-posi-tive cluster form

Streptococcal Subacute Watery mucoid dis-conjunctivitis charge, conjunctival swelling, pseudomem-branes

Streptococci: Gram-posi-tive chain form

Streptococci: Gram-posi-tive chain form

Pneumococcal Acute Moderately purulent conjunctivitis discharge, chemosis, multiple subconjunctival hemorrhages, corneal ulceration

Pneumococci: Brightly encapsulated Gram-positive lancet-shaped diplococci

Topical: broad-spec-trum antibiotic (such as neomycin, kanamy-cin, tetracycline, gen-tamicin, or chloramphenicol)*

Diphtheric Acute Moderately purulent conjunctivitis discharge, adhesive

(must be coverings (mem-

reported) branes) dominate, conjunctival necrosis, eyelid edema

Gram-positive diplobacilli

Gram-positive diplobacilli

Topical: broad-spec -trum antibiotic (see above)

Systemic: 300-500 units per kg of diphtheria antitoxin IV; antibiotics: penicillin, tetracycline

Gonococcal Hyper- Creamy purulent dis-

conjunctivitis acute charge, bright red con junctiva, swollen eyelids and conjunctiva

Gonococci (Neisseria gonorrhoeae): intracellular Gram-negative diplococci

Topical: broad-spec-trum antibiotic (gen-tamicin, kanamycin, tetracycline, chloramphenicol)*

Systemic: penicillin for

- Newborn: 1 mega-unit per day

- Children: 2 mega-units per day

- Adults: 4-5 mega-units per day

Continued-

Table 4.2 (Continued)

Cause

Clinical course

Symptoms and findings

Pathogen

Treatment

Bacteria

Pseudomonas conjunctivitis

Hyperacute

Purulent discharge, often with corneal involvement. Fulminant course: infection may be spread by unsterile eyedrop bottles and contact lens holders. The bacterium emits an enzyme (proteoglycan) that can penetrate the cornea within 24 hours.

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