Diferencia entre revisiones de «Bacterial conjunctivitis»

Revisión del 18:50 25 oct 2011

Background

Often due to staph and strep

Clinical Features

Painless, unilateral or bilateral mucopurulent discharge
1. Often causes adherence of the eyelids on awakening
Chemosis is common

Diagnosis

Perform fluorescein stain of cornea (esp in infants) to avoid missing corneal lesion

DDx

Eye Algorithm (Main)

Treatment

Topical abx
1. Adults
  1. Polymyxin-trimethoprim 1-2 drops QID x5-7d
2. Peds
  1. Erythromycin ointment 1/2" QID x5-7d OR
3. Contact lens wearer
  1. Fluoroquinolone ophthalmic drops 1-2 drops QID x5-7d (covers pseudomonas)
  2. Discontinue contact lens wearing
Culture
1. Consider for severe cases

Disposition

Follow-up (if no improvement) in 3-4d

Source

Mahmood, Narang. Diagnosis and management of acute red eye. Emerg Med Clin N Am. 2008;26
Tintinalli

Authors:

@@ Línea 1: / Línea 1: @@
 ==Background==
-===Causes===
+*Often due to staph and strep
-#gram-positives
-##Streptococcus pneumoniae
+==Clinical Features==
-##Staphylococcus aureus
+#Painless, unilateral or bilateral mucopurulent discharge
-#gram-negatives
+##Often causes adherence of the eyelids on awakening
-##Haemophilus influenzae
+#Chemosis is common
 ==Diagnosis==
-#More abrupt onset (than viral)
+*Perform fluorescein stain of cornea (esp in infants) to avoid missing corneal lesion
-#Normally spreads bilateral within 48hrs
-#Morning crusting
 ==DDx==
-[[Eye Algorithm (Main)]]
+*[[Eye Algorithm (Main)]]
 ==Treatment==
-#Topical ophthalmi antibiotic
+#Topical abx
-##Erythromycin, OR
+##Adults
-##Bacitracin/Polymyxin B
+###Polymyxin-trimethoprim 1-2 drops QID x5-7d
-###If contact lens wearer, cover for pseudomonas
+##Peds
-####discontinue lens wearing
+###Erythromycin ointment 1/2" QID x5-7d OR
-####Topical fluoroquinolone
+##Contact lens wearer
-####Eg: Cipro drops 10D OU
+###Fluoroquinolone ophthalmic drops 1-2 drops QID x5-7d (covers pseudomonas)
-#Follow-up (if no improvement) 3-4 days
+###Discontinue contact lens wearing
-##Closer follow-up in young children and the debilitated (obtain cultures)
+#Culture
+##Consider for severe cases
-*Ointment for children
+==Disposition==
-*Drops for adolescents/adults
+#Follow-up (if no improvement) in 3-4d
 ==See Also==
@@ Línea 33: / Línea 32: @@
 ==Source==
-* Mahmood AR, Narang AT. Diagnosis and management of the acute red eye. Emerg Med Clin N Am. 2008;26:35-55.
+*Mahmood, Narang. Diagnosis and management of acute red eye. Emerg Med Clin N Am. 2008;26
+*Tintinalli
 [[Category:Ophtho]]
 [[Category:ID]]