Conjuntivitis aguda causada por el virus respiratorio sincitial grupo A / Acute conjunctivitis caused by respiratory Syncytial virus A group

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Corneal superinfection in acute viral conjunctivitis in young children.

Two children suffered from corneal superinfection following acute viral keratoconjunctivitis. Group A beta-hemolytic streptococci were isolated in one child and cultures were negative in the other child. The corneal ulcers resolved with prompt antibiotic therapy, but both patients developed amblyopia. Visual outcome following corneal superinfection in acute viral conjunctivitis may be poor when it occurs in young children.

Oxybuprocaine induces a false-positive response in immunochromatographic SAS Adeno Test.

OBJECTIVE: To investigate whether a solution of oxybuprocaine hydrochloride, 0.4%, results in a false-positive response in an immunochromatographic SAS Adeno Test. DESIGN: Experimental study. CONTROLS: Physiologic saline and 2% lidocaine. TESTING: Each chemical (100 microl) was diluted in a transport medium. Five drops (200 microl) of the resultant solution were dispensed into the round sample well of a test device. Fifteen samples were tested in each group. MAIN OUTCOME MEASURES: Ten minutes after the start of the test, a colored line in the "specimen" portion of the test membrane was visually read as positive or negative by a masked technician. RESULTS: No positive reaction was observed in the control groups (physiologic saline and lidocaine). A false-positive reaction was observed in six samples (33.3%) in the oxybuprocaine group. The positive rate was significantly higher in the oxybuprocaine group compared with those in control groups (P = 0.0062, Fisher's extract probability test). CONCLUSIONS: Oxybuprocaine may induce a false-positive reaction in an immunochromatographic SAS Adeno Test. We recommend the use of lidocaine, instead of oxybuprocaine, for local anesthesia in taking eye swabs from patients with suspected adenovirus infection.

Conjunctival scrapings and impression cytology in chronic conjunctivitis. Correlation with microbiology.

To assess the utility of exfoliative cytology in the diagnosis of chronic conjunctivitis, we compared its findings with microbiological examination and established the correlation between cytology and microbiology in 32 patients with conjunctivitis lasting four weeks or more, with a nonspecific clinical picture. The material for cytology was collected by scraping and by imprint of the ocular surface on Millipore filter paper. The specimens were stained with Giemsa. Material for bacterial culture and fluorescent antibody test for viruses and Chlamydia were obtained at the same time. In 12 patients neutrophils predominated in cytology, in six eosinophils were found and in four there were more lymphocytes. One patient had a basophilic intracytoplasmic inclusion specific for Chlamydia infection. In eight patients coagulase-negative Staphylococcus species and in one Staphylococcus aureus were isolated, in two the fluorescent antibody test for Chlamydia was positive and in three for viruses. In all patients with a positive bacterial culture, a predominance of neutrophils was observed. All patients with a positive test for viruses had lymphocytosis in conjunctival scrapings. In two patients microbiology detected Chlamydia, but characteristic intracytoplasmic inclusions were observed only in one. Scrapings gave more specific results, that correlated well with microbiology in bacterial and viral infection, whereas the results of impression cytology showed minor metaplastic changes of epithelial cells that were nonspecific for the type of inflammation. Cytology remains a useful non-invasive tool and is an adjunct to clinical and microbiological examination. It proved especially helpful in allergic conjunctivitis.

Conjunctivitis caused by human parvovirus B19 infection.

A 26-year-old woman with erythema infectiosum is reported. She had small faint erythemas on her extremities and congestion of palpebral and bulbar conjunctiva of both eyes. Human parvovirus B19 (B19) DNA was detected in the specimen of the conjunctiva by the polymerase chain reaction. This result suggests that conjunctivitis in erythema infectiosum may cause the B19 infection.

Outbreak of adenovirus type 4 conjunctivitis in South Australia.

An outbreak of adenovirus type 4 conjunctivitis occurred in South Australia between April and November 1992. Eye swabs were submitted by general practitioners and ophthalmologists who had seen patients with clinical conjunctivitis or keratitis. Apart from interfamilial spread, there were no other common epidemiological factors. Adenovirus was isolated from the eye swabs of 38 patients. Isolates were typed by neutralisation tests and restriction endonuclease cleavage patterns and found to be adenovirus type 4. This report serves to illustrate an infrequent cause of epidemic conjunctivitis, namely adenovirus type 4. There was no demonstrable focus of the outbreak.

Adenovirus isolations from patients with conjunctivitis in Thuringia.

57 adenoviruses (AV's) isolated from 1979 through 1986 from about 200 patients with (kerato) conjunctivitis were identified as AV8, 7, 3, 17/H29, 9, 2, and 10, in decreasing order. DNA restriction analysis with 5 enzymes revealed the three strains of the intermediate 17/H29 strains to be identical. The same conclusion was reached for the two AV9 strains, but the latter differed from the AV9 prototype in two enzymes. Restriction site alterations were physically mapped for 3 enzymes and for an AV8 variant differing in HindIII.

Molecular epidemiology of adenovirus conjunctivitis in Glasgow 1981-1991.

Adenoviruses isolated over a period of 10 years from patients with conjunctivitis were typed by neutralisation test using reference sera and by restriction endonuclease fragment (REF) analysis. Adenoviruses were isolated from 516 of 10,232 patients tested (5.0%); 154 were identified as type 3, 153 as type 4, 70 as type 7, 17 as type 10 and 122 as other types. At any one time, several serotypes co-circulated. The prevalence of types varied. Type 4 was not isolated in the first 2 years and then gradually increased in incidence, becoming the most frequently isolated type after 1987. Two periods of increased isolation frequency occurred: firstly from May to August 1981, when 8-28% of patients per month were found to be adenovirus-positive, with serotype 3 being predominant; and secondly from January 1989 to August 1990, when 8-20% of patients per month were adenovirus-positive, predominantly with type 4. Analysis of REFs showed that several different genotypes exist within serotypes. These also co-circulated over long periods with intermittent changes of the predominant genotype. The prototype strain Ad3GB was isolated more frequently than five other Ad3 genotypes from 1981 to 1988, after which a variant strain Ad3a was most common.

Concomitant oculoglandular and ulceroglandular fever due to herpes simplex virus type I.

Herpes simplex virus is a commonly encountered infectious agent in clinical practice. The syndromes with which it is usually associated are well described and generally easily recognized. This report documents that two uncommon clinical syndromes, ulceroglandular fever and oculoglandular fever, may be caused by this virus. Our patient's case was even more unusual in that both conditions occurred simultaneously.

Adenovirus pneumonia with severe sequelae in an immunocompetent adult.

Notable complications from adenovirus pneumonia in healthy adults are rare. We report a well-documented case of adenovirus type 3 infection in a previously well adult woman that resulted in severe pulmonary complications as well as self-limited ocular, hepatic, and gastrointestinal abnormalities.

Inhibitory effect of (S)-HPMPC, (S)-HPMPA, and 2'-nor-cyclic GMP on clinical ocular adenoviral isolates is serotype-dependent in vitro.

Currently, there is no effective treatment for ocular adenoviral infections that occur in epidemics worldwide, produce significant patient morbidity, and cause substantial economic losses. We tested several new antivirals in vitro, and found that (S)-HPMPC, (S)-HPMPA, and 2'-nor-cyclic GMP demonstrated significant serotype-dependent inhibitory activity by plaque reduction assay (ID50 = 0.017-17.0 micrograms/ml) against common clinical ocular isolates and standard adenoviral serotypes (Ad 1, Ad 5, Ad 8, and Ad 19). (S)-HPMPC was the least toxic (CD50 in A549 cells = 306 micrograms/ml), and (S)-HPMPC and (S)-HPMPA had high selectivity indices.

Intermediate human adenovirus type 22/H10,19,37 as a new etiological agent of conjunctivitis.

Eight strains of a new intermediate adenovirus were isolated in the course of an investigation of conjunctivitis in Hiroshima City, Japan. The strain was first isolated in July 1986. All eight strains were isolated from conjunctival swab samples from patients with conjunctivitis, mainly epidemic keratoconjunctivitis. The virus was typed as adenovirus type 22 in neutralization tests and was related closely to types 10, 19, and 37 in hemagglutination inhibition tests. The DNA cleavage patterns of the eight strains with nine restriction endonucleases were the same with one exception but different from those of the above serologically related species. We conclude that the intermediate adenovirus is a new etiological agent of conjunctivitis, mainly epidemic keratoconjunctivitis.

Infection of rhesus monkeys with topical instillation of simian immunodeficiency virus (SIV)B670 into the conjunctival sac.

We tested the ability of SIV to cause local and systemic infection in three rhesus monkeys after topical instillation of cell-free virus into the conjunctival cul-de-sac. Conjunctivitis or other signs of infection were monitored after inoculation. Conjunctiva were swabbed for virus culture and biopsied for PCR. Changes in lymphocyte subsets, seroconversion, antigenemia, and virus isolation from PBL were assessed systemically postinoculation. Viral DNA was detected in conjunctival biopsy by PCR in one of three animals that later developed systemic infection. The other two animals remained uninfected. These data demonstrate that the conjunctiva is a route by which SIV (and perhaps HIV) may cause systemic infection.

Chronic sialodacryoadenitis virus (SDAV) infection in athymic rats.

Sialodacryoadenitis virus (SDAV) was detected in athymic rats subcutaneously implanted with human tumor cell lines. Clinical signs included sneezing, dyspnea, weight loss and death. Necropsy revealed both upper and lower respiratory tract disease from which Staphylococcus aureus, Pasteurella pneumotropica and Pseudomonas aeruginosa were recovered. Histopathological changes consisted of suppurative rhinitis and bronchopneumonia. Lesions characteristic of SDAV infection were found in lacrimal and salivary glands, and viral antigens were detected in the salivary glands and respiratory tract by immunohistochemistry. Submaxillary salivary gland. Harderian gland and lung homogenates from affected athymic rats were inoculated intranasally into euthymic rats as a rat antibody production test. All euthymic rats seroconverted to SDAV. Seroconversion to SDAV was demonstrated in consecutive pairs of sentinel euthymic rats housed for 6 months with infected athymic rats. Inoculation of supernatants of the original tumor cell lines into euthymic rats did not result in seroconversion. The source of the virus was not determined. In this study, spontaneously acquired SDAV infection persisted for at least 6 months in athymic rats.

[Tropical conjunctivitis: infectious etiology and validation of its clinical features]. / Conjonctivites tropicales: étiologie infectieuse et validation des caractères cliniques.

173 nontrachomatous conjunctivitis studied at the I.O.T.A. in Bamako, Mali, have shown a majority of bacterial aetiology, especially gram-negative. 1 out of 10 conjunctivitis was due to virus, mostly to adenovirus. 4% of the cases were due to Chlamydia Trachomatis. The try of validation of the clinical characters in comparison with the etiology has shown that Chemosis was an indicator of a bacterial conjunctivitis (OR = 2.4) and that the lack of purulent discharge was in connexion with the presence of a keratitis (OR = 7.7). On the one hand the frequency of gram-negative bacteria, on the other hand the potential gravity of the conjunctivitis in tropical area, would justify the use of gentamycin at first in nontrachomatous conjunctivitis.

Acute non-haemorrhagic conjunctivitis due to coxsackievirus A24.

Two cases of acute non-haemorrhagic conjunctivitis due to coxsackievirus A24 (CA24) are described. These are the first Australian isolates. The presentation was as a severe conjunctivitis in otherwise healthy adults who had not travelled outside Australia. The course was of short duration and self-limiting with no long-term sequelae. The isolates could not be neutralised by antiserum prepared against prototype CA24 but were identified by immune electron microscopy and complement fixation.

Viral and bacterial conjunctivitis. Prevention of disastrous results.

Conjunctivitis has many bacterial and viral causes. If the cause is bacterial, treatment with a broad-spectrum antibiotic resolves the problem in 1 to 3 days in almost all cases. If signs and symptoms persist, referral to an ophthalmologist is wise. Most cases of viral conjunctivitis are accompanied by follicular reactions in the inferior fornix, as observed with adult inclusion disease. If dendrites are seen, trifluridine (Viroptic) is preferred for treatment. Referral to an ophthalmologist is advisable because recurrence with scarring and permanent loss of vision is possible. Many topical antibiotics include a corticosteroid component that never should be used unless the conjunctivitis or keratitis is proven to be nonherpetic.