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bacterial conjunctivitis

see conjunctivitis Classification: - acute bacterial conjunctivitis - hyperacute bacterial conjunctivitis due to Neisseria Etiology: - Staphylococcus aureus (most common) - Streptococcus pneumoniae - Haemophilus - Pseudomonas in contact lens wearers Epidemiology: - highly contagious - spread by person-to-person contact or through contact with contaminated surfaces Clinical manifestations: - acute bacterial conjunctivitis - most commonly present after several days of symptoms - unilateral* diffuse conjunctival redness & discharge - thick yellow or green discharge [2] - may awaken with eyelids stuck together - visual blurring that improves with blinking - overt changes in visual acuity do not occur - hyperacute bacterial conjunctivitis due to Neisseria - sudden onset - profuse purulent discharge - diffuse bright red conjunctival hemorrhage - rapid progression to vision loss * bilateral involvement may occur Management: - acute bacterial conjunctivitis - frequently self-limiting - antibiotic eye drops is associated with modestly improved rates of clinical & microbiological remission [1]; NNT = 7 [1] - choice of antibiotic is generally empiric [2] - trimethoprim-polymyxin B ophthalmic - fluoroquinolone ophthalmic if patient wears contact lens (Pseudomonas) - hyperacute bacterial conjunctivitis due to Neisseria - emergency ophthalmology consult, hospitalization - both topical & systemic antibiotics indicated

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conjunctivitis

References

  1. The NNT: Topical Antibiotics for Clinical Cure of Bacterial Conjunctivitis http://www.thennt.com/nnt/topical-antibiotics-for-bacterial-conjunctivitis/ - Sheikh A, Hurwitz B, van Schayck CP, McLean S, Nurmatov U Antibiotics versus placebo for acute bacterial conjunctivitis. Cochrane Database Syst Rev. 2012 Sep 12;9:CD001211 PMID: 22972049
  2. Medical Knowledge Self Assessment Program (MKSAP) 17, 18, 19. American College of Physicians, Philadelphia 2015, 2018, 2022