Bacterial Conjunctivitis
Bacterial infection of conjunctiva In normal hosts, usually benign, self-limited, rare and caused by organisms susceptible to wide variety of topical anti-infective agents In abnormal hosts (neonates, immunocompromised states, chronic contact lens wear, following ocular trauma or surgery), sometimes vision-threatening and even life-threatening process that is difficult to treat In neonates, major concern is gonococcal conjunctivitis In adults, major concerns are pseudomonas, proteus, Bacillus cereus, acanthamoeba
Soreness, tightness, heat, and often pain in affected eye Fiery red, boggy conjunctiva Thick, yellow or white discharge (pus) Swollen lids
Consult ophthalmologist promptly if host is abnormal (including neonates) or if vision is reduced Demonstrate to patient or caregiver proper way to instill eye drops Treat with one of following anti-bacterial medications: Sulfacetamide 10% Broad-spectrum coverage, inexpensive, BUT... Occasional contact dermatitis of lids Rare allergic Stevens Johnson Syndrome (erythema multiforme) Ineffective against rare virulent gram-negative organisms Trimethoprim/polymixin B Broad spectrum coverage, BUT... Expensive Aminoglycosides (gentamicin, tobramycin eyedrops or ointment) Broad-spectrum coverage, effective against most gram-negative species, BUT... Expensive Keratitis Fluoroquinolones (ciprofloxacin, ofloxacin, norfloxacin) Broad-spectrum coverage, effective against most gram-negative species, BUT... Very expensive
In normal hosts, manifestations usually resolve within days of starting treatment In abnormal hosts, and with potent and unusual organisms, infection may be hard to treat and threaten sight
