Ophthalmia neonatorum

To measure the frequency of ophthalmia neonatorum among all babies born in MCH Center, PIMS [Pakistan Institute of Medical Sciences], Islamabad, in one month's time and to determine their causative organisms. An observational study. The MCH Center, PIMS, during the month of November 2008. All babies born from 1st to 30th November, 2008 in the MCH Center, PIMS, Islamabad, Pakistan were included in the study. All babies were examined for signs of conjunctivitis on days 1, 3, 7, 14, 21 and 28 of life. Conjunctival swabs were taken for gram staining and culture from those with clinical diagnosis of conjunctivitis. Frequency of known maternal and neonatal risk factors for the disease were assessed. Proportions were compared using chi-square test with significance at p <0.05. Seventeen percent of the 1010 babies developed conjunctivitis. Staphylococcus aureus [65% of all positive cultures] was the most common causative organism. No case of gonococcus was isolated. Meconium stain liquor [p=0.004] and caesarain section [p <0.001] were found to be the most frequent associated conditions in conjunctivitis. There was a high frequency of neonatal conjunctivitis, with Staphylococcus aureus as the most common causative agent. Poor hygienic conditions and practices could be an important risk factor in Pakistan

Conjuntivite por Achromobacter xylosoxidans: relato de caso / Conjunctivitis due to Achromobacter xylosoxidans: case report

Relatamos um caso de conjuntivite ocasionada por Achromobacter xylosoxidans em paciente imunocompetente usuária de lentes de contato rígidas. A bactéria foi isolada da solução utilizada para a desinfecção das lentes bem como do raspado conjuntival. A. xylosoxidans tem sido descrita em infecções oportunistas em pacientes imunodeprimidos, contudo pode ser confundida com outros bacilos gram-negativos, principalmente Pseudomonas aeruginosa, isoladas de infecções oculares em pacientes imunocompetentes. Devido ao reduzido perfil de sensibilidade aos antimicrobianos demonstrado pelo A. xylosoxidans, torna-se importante a identificação deste agente etiológico em quadros de conjuntivite.

We report here a case of conjunctivitis in an immunocompetent patient due to Achromobacter xylosoxidans, which was associated with the use of rigid contact lenses. The bacteria were isolated from the scraped conjunctival swab as well as from the lens cleaning fluid. A. xylosoxidans is an opportunistic pathogen, especially in immunocompromised patients; however, in isolates of ocular infections, from immunocompetent patients, it may be confused with other gram-negative organisms, particularly Pseudomonas aeruginosa. Due to an increased resistance against different antimicrobial agents, A. xylosoxidans must be fully identified and differentiated from other gram-negative isolates from ocular infections.

Curso de atualização em emergências médicas: aula 9: conjuntivites infecciosas agudas / Updating medical emergencies course: class 9: acute infectious conjunctivitis

Conjuntivite é todo processo inflamatório que envolve a membrana conjuntiva, independente da causa. A hiperemia conjuntival é um achado clínico sempre presente, podendo estar associado à secreção. Entretanto, a maior parte dos sinais clínicos só pode ser bem identificada com auxílio da microscopia clínica. Pode ser causada por agentes bacterianos ou virais, mas também por irritantes químicos como medicamentos, filtros solares e cremes faciais.

Conjunctivitis is an inflammatory disease affecting conjunctive membrane, independet of etiology. Conjunctival hyperemia is always present and might come together with ophthalmic discharge. Nevertheless, the majority of clinical signs can only be recognized using microscopy. The acute disease may be due to bacterial or viral infection. Other causes include chemical irritants as drugs, suscreen of facial lotion.

Microbiota conjuntival em pacientes com alergia ocular / Conjunctival microbiota in patients with ocular allergy

OBJETIVO: Avaliar a presença de microbiota aeróbia da conjuntiva de portadores de alergia ocular e comparar a um grupo controle. MÉTODOS: Foram examinados 133 pacientes no período de abril a junho de 2001 divididos em 2 grupos. O grupo A foi composto de 63 portadores de conjuntivite alérgica (sem uso de medicação) e o grupo B de 70 pacientes do ambulatório geral (controle). Foram coletadas amostras do fundo de saco conjuntival do olho direito de todos os pacientes e o material foi semeado em meios sólidos de cultura (ágar sangue, chocolate e Sabouraud). RESULTADOS: No grupo A, 30 culturas (47,7 por cento) foram positivas e no grupo B, 6 (8,6 por cento). Sete bactérias foram isoladas no grupo A e 4 no B. A análise estatística revelou associação significante entre a positividade dos cultivos e conjuntivite alérgica. CONCLUSÃO: Microbiota bacteriana foi mais freqüentemente encontrada nos pacientes com alergia ocular.

A hospital based study on the prevalence of conjunctivitis due to Chlamydia trachomatis.

BACKGROUND & OBJECTIVES: Very few studies have been done in India to determine the prevalence of Chlamydia trachomatis causing conjunctivitis using polymerase chain reaction (PCR) methods. Hence the prevalence of primary conjunctivitis due to C. trachomatis among individuals attending ophthalmic hospitals in Chennai was determined and compared with our earlier results. METHODS: A total of 328 conjunctival swabs from 255 (both eyes 73 and one eye 182) patients were investigated by fluorescent antibody test (FAT) on direct smears, culture and PCRs for cryptic plasmid and major outer membrane protein (MOMPI) gene of C. trachomatis. An infant with ophthalmia neonatorum was also included. RESULTS: Among these 328 specimens processed, 16 (4.9%) from 12 (4.7%) patients were positive by cryptic plasmid PCR. Among these, 3 from 2 patients were positive by FAT (direct smear), culture and PCR for MOMP 1 gene. Both eyes of the infant with ophthalmia neonatorum were positive by all the methods. The sensitivity of FAT and culture (18.8%) was lower compared to PCR. INTERPRETATION & CONCLUSION: A significant decrease in the prevalence of adult chlamydial conjunctivitis has occurred in the 10-year period among patients reporting to the ophthalmic hospitals in Chennai. PCR using cryptic plasmid primers was found to be the most sensitive method to detect C. trachomatis in patients with conjunctivitis.

Conjuntivitis bacteriana en la población adulta: frecuencia de las especies detectables mediante cultivos microbiológicos / Bacterial conjunctivitis in adults: frequency of pathogen bacterias detectables by microbiologic culture

Los actuales niveles de la contaminación ambiental en la Ciudad de México han originado un incremento de las enfermedades cutáneas, respiratorias y oculares debido, entre otras razones, a que ocasionan irritaciones en la piel, en las mucosas respiratorias y en las conjuntivas, favoreciendo el establecimiento y la reproducción de diversos microorganismos patógenos en dichos tejidos. En este trabajo se llevaron a cabo los análisis bacteriológicos tanto de 242 exudados conjuntivales provenientes de pacientes adultos que presentaban una clara conjuntivitis, como de 150 muestras conjuntivales no patológicas, obteniéndose los siguientes resultados: 1) El 62.8 por ciento de los especímenes patológicos contenía al menos una bacteria patógena detectable mediante cultivos microbiológicos. 2) Staphylococcus aureus causa más de la mitad de los casos de conjuntivitis en nuestro medio. 3) Las frecuencias de Streptococcus pyogenes y Streptococcus pneumoniae son mayores que las de Eschirichia coli, Haemophilus influenzae y Moraxella sp. 4) Una o dos de todas las especies antes mencionadas sólo se encuentran presentes en el 15 por ciento de las muestras conjuntivales provenientes de los individuos aparentemente sanos

Evaluation of laboratory tests for diagnosis of chlamydial infections in conjunctival specimens.

We evaluated the chlamydial direct diagnostic tests and McCoy cell culture methods for detection of Chlamydia trachomatis in 234 conjunctival scrapings from 127 patients. Direct (rapid) diagnostic methods of Giemsa stain cytology, fluorescent antibody test (FAT) and immunoperoxidase (IPO) stain and McCoy cell culture isolation method using IPO staining and FAT for detection of C. trachomatis antigen were carried out. McCoy cell culture isolation using FAT antigen detection method was considered as the gold standard. The specificity of all the direct diagnostic tests were above 90 per cent but sensitivity of Giemsa cytology, FAT and IPO stain were 36, 54 and 53 per cent respectively showing that as direct diagnostic tests Giemsa stain cytology was inefficient and FAT and IPO were useful. Specificity and sensitivity of McCoy cell culture using IPO stain for detection C. trachomatis antigen were above 90 per cent and it is suggested that this test can be used as a routine diagnostic method.

Development & use of antichlamydial monoclonal antibodies for rapid diagnosis of follicular conjunctivitis.

We developed four independent murine hybrid clones producing IgG class and genus specific monoclonal antibodies against the major outer membrane protein (MOMP) of Chlamydia trachomatis, L2 serovar. All antibodies reacted with a single epitope of MOMP. In indirect immunofluorescence assay using one of the antibodies chlamydiae could be detected in 12 of 23 conjunctival scrapings from patients of follicular conjunctivitis. Giemsa staining could detect classical inclusion bodies in only 5 of these 23 smears. Antigen detection using these monoclonal antibodies may be used as a rapid diagnostic test in clinical and epidemiological screening for chlamydial infection.

Cytological evaluation of conjunctival scrape smears in cases of conjunctivitis.

The present study was conducted on 130 cases of untreated conjunctivitis and 25 control cases to assess the diagnostic value of cytology. Conjunctival scrapings from all cases were stained with Giemsa and Papanicoloau's stain and categorized cytologically and later correlated with the clinical profile. Normal cytologic profile was obtained in 7 cases (5.4%) of the study group and 14 cases (56%) of the control group. Cytologic diagnosis of trachoma was made in 63 cases (48.5%) including 48 out of 51 clinically diagnosed cases of trachoma, 9 cases of allergic conjunctivitis and 6 cases of acute follicular conjunctivitis, positive clinico cytologic correlation being 76.2%. Mucopurulent conjunctivitis was diagnosed in 24 cases (18.5%) both clinically as well as by cytological technique. Viral conjunctivitis was diagnosed in 24 cases (18.5%) including 19 cases (14.6%) of clinically diagnosed viral conjunctivitis and 5 cases (3.9%) of acute follicular conjunctivitis, positive correlation being 79.2%. Only 2 cases (1.5%) out of 15 clinically diagnosed cases of allergic conjunctivitis were confirmed cytologically. In all the 4 cases (3.1%) of spring catarrh and 6 cases (4.6%) of phlyctenular conjunctivitis the cytologic features were found to be consistent with the clinical diagnosis.

Ojo rojo / Red eye

Se señala que existen 2 variedades de ojo rojo, de los cuales uno es debido a inyección conjuntival y corresponde a los diversos tipos de conjuntivitis (bacterianas, virales y alérgicas) y el otro a la inyección ciliar o periquerática, propia de las afecciones de la córnea y del iris así como del glaucoma agudo. Desde el punto de vista de manejo y conducta, si el paciente presenta una clara inyección conjuntival con secreción y sin dolor, puede ser tratado por un médico general o un pediatra. Por el contrario, si el ojo rojo se debe a un halo violáceo que rodea la cornea y el diagnóstico no aparece claro, el paciente debe ser referido de inmediato al oftalmólogo ya que un mal manejo puede exponerlo a la pérdida de la visión

Bronconeumonía por Chlamydia trachomatis con enfermedad isquémica intestinal: presentación de un caso / Bronchopneumonia by Chlamydia trachomatis with ischemic intestinal disease Report of case

Se presenta el caso de un paciente de dos meses de edad por infección Chlamydia trachomatis, con los signos clínicos clásicos: conjuntivitis, infección respiratoria, e insuficiencia ventilatoria, con septicemia agregada y enfermedad isquémica intestinal. Se corroboró la infección en la madre y con ello la vía de adquisición de la enfermedad