Bacterial conjunctivitis: how dangerous is the disease?

Conjunctivitis is one of the most common eye diseases that both children and adults have to face. The disease is an inflammatory process in the connective shell of the eyeball - conjunctiva. The prevalence of this pathology among the population is due to the contagious nature of certain types of conjunctivitis (and especially bacterial), as well as the accessibility of the mucous membrane of the eye for the action of damaging agents. In this article, we will consider the specific features of bacterial conjunctivitis.

What it is?

Bacterial conjunctivitis is a very common and usually self-limiting inflammatory disease of the conjunctiva, which most often affects children.

Bacterial conjunctivitis is caused by various bacteria.

With the lightning-fast form of bacterial conjunctivitis, the clinical symptoms are more pronounced and progress more rapidly than in the acute form. In the etiology of this form, the main role is played by Neisseria gonorrhoeae. Inflammation is characterized by edema of the conjunctiva and eyelids and abundant purulent discharge. Usually the incubation period is 1-3 days.

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The cause of gonococcal conjunctivitis in adults is urogenital gonococcal infection. A newborn child may become infected while passing through the birth canal.

For acute bacterial conjunctivitis, the mucopurulent nature of the discharged and predominant lesion of the bulbar conjunctiva is characteristic.Clinical symptoms usually fade after 10-14 days, sometimes even without special therapy. However, with conjunctivitis caused by Staphylococcus aureus and Moraxella catarrhalis, the disease can become chronic. AlsoStaphylococci have the ability to colonize the edges of the eyelids and cause chronic blepharitis.

Premococcal

Pneumococcal conjunctivitis, as a rule, is cured independently and is accompanied by subconjunctival hemorrhages, as well as conjunctivitis caused by Haemophilus influenzae (aegyptius biogroup), endemic for tropical and subtropical regions. Conjunctivitis caused by Streptococcus pyogenes is characterized by the formation of pseudomembranes on bulbar conjunctiva.

Pseudomonas aeruginosa

Pancreatic conjunctivitis occurs infrequently, but its danger is a high risk of infection cornea, especially with prolonged use of contact lenses, as well as traumatic lesions cornea.

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Causes and risk factors

Infection with bacterial conjunctivitis occurs usually due to direct contact with the infected discharge.

Bacterial conjunctivitis is more often caused by Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus sp., Less often Chlamydia trachomatis, Neisseria gonorrhoeae (gonococcal conjunctivitis), which is usually the result of sexual contact with a person who has a urogenital infection.

Conjunctiva is characterized by high resistance to infections.Tear fluid, which has antibacterial activity due to the content of immunoglobulins, lactoferrin, lysozyme and beta-lysine, in combination with the function of the eyelids, reduces the amount of bacteria on the the surface of the eye.

Local risk factors for bacterial conjunctivitis include:

• traumatic injuries;
• presence of foreign bodies;
• some skin diseases;
• infection of lacrimal ducts.

Bacterial conjunctivitis occurs in 20-40% of newborns who have passed through the infected birth canal. Most often in this case, the disease is associated with maternal gonococcal or chlamydial infection.

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Symptoms

Bacterial conjunctivitis, as a rule, begins acutely: first one eye is affected, and another 2-3 days later. Appears mucous or purulent discharge, accumulating in the corner of the eye.In severe forms, it can drain over the edge of the eyelid, glue eyelashes, and it is difficult for the patient to open his eyes. Disturb the sensation of a foreign body in the eye, itching, burning.

When delaying treatment, the disease can go on into a chronic form, when short periods of remission alternate with a prolonged exacerbation.In a patient with chronic conjunctivitis often become inflamed and quickly tired eyes, there is a scant separable. In connection with the increased risk of chronicization of the pathological process, it is recommended to undergo the correct treatment, and self-medication is not worth it. From the first symptoms it is necessary to consult a qualified eye specialist.

Diagnostics

As a rule, the diagnosis of bacterial conjunctivitis is not difficult.However, for greater confidence and effectiveness of therapy before treatment, it is recommended to give a smear from the conjunctiva to pathogenic flora and sensitivity to antibiotics.You should know that before such an analysis within 3 days nothing to drip in the eye is not necessary.

Treatment

Bacterial conjunctivitis is very contagious, so all necessary measures must be taken to prevent the spread of infection.

If gonococcal or chlamydial infection is not suspected, then most often conjunctivitis is treated in for 7-10 days with drops of moxifloxacin (,%) 3 times a day or with trimethoprim / polymyxin 4 times in day.If there are no signs of improvement in 2-3 days, then the disease has a viral (allergic) nature or there is resistance of the bacteria to the prescribed treatment.Further, the culture and sensitivity to antibiotics are sown and subsequent treatment is determined.

Read more about the treatment of viral conjunctivitis in adults.

Inflammation of the conjunctiva

Gonococcal conjunctivitis is treated in adults with ceftriaxone (1 g) intramuscularly or ciprofloxacin (500 mg) 2 times a day for 5 days.Additionally, bacitracin 500 g / g or,% ointment gentamicin may be given. At the same time, sexual partners must also be treated. Because patients with gonorrhea often have chlamydial urogenital infection, patients should also receive azithromycin (1g) or doxycycline 100 mg twice daily for 7 days.

Bacterial conjunctivitis is prevented in newborns by means of drops of silver nitrate or erythromycin immediately at birth. Infections that have not been suppressed in this way require systemic therapy.When gonococcal infection is usually given ceftriaxone 25-50 mg / kg intravenously or intramuscularly once a day for 7 days.Chlamydia conjunctivitis is treated with erythromycin at 1, mg / kg 4 times a day for 14 days. Necessarily together with the child are treated and parents.

A simple bacterial conjunctivitis usually passes even without treatment for 10-14 days, so laboratory tests are usually not performed.

Before the treatment of bacterial conjunctivitis, the eyelids should be cleared and mucus removed from them.Until the separated, it is necessary to use antibacterial agents of a wide spectrum of action in the form of drops and ointments (before bedtime).

Drops are necessarily used to treat bacterial conjunctivitis.

The basic preparations:

• Fusidic acid (fucitalmic).This viscous suspension is used for infection of staphylococcal nature. Initial treatment - 3 times a day for 48 hours, then 2 times a day.
• Chloramphenicol.The drug has a wide range of effects, and it is prescribed every 1-2 hours.

Other antibacterial drugs:

• Ciprofloxacin.
• Ofloxacin.
• Lomefloxacin.
• Gentamicin.
• Neomycin.
• Framicytin.
• Tobromycin.
• Nesporin.

Antibiotics in the form of ointments provide a higher concentration over a longer period than drops, but they should only be used before bedtime, as they cause a erased current disease.

At night, the ointments effectively affect the course of treatment. Antibiotics in the form of ointments:

• Chloramphenicol.
• Gentamicin.
• Tetracycline.
• Framicetin.
• Polifax.
• Polytrim.

Complications

One of the frequent complications of conjunctivitis, which leads to severe consequences with a possible loss of vision, is keratitis. Additional risk factors:

• prolonged exposure of the eyelids in the closed state;
• wearing soft contact lenses;
• traumatic damage to the corneal epithelium.

To minimize the risk of keratitis, it is important to take preventive measures in the form of topical antibiotic use.

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Prevention

Prevention of bacterial conjunctivitis is the observance of hygiene standards, prevention eye injuries, proper care of contact lenses, timely repayment of foci of skin infection and nasopharynx.In children's groups where cases of bacterial conjunctivitis have been reported, it is necessary to prescribe preventive treatment for all contact persons.

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conclusions

So, bacterial conjunctivitis in children and adults can be dangerous for human health. It is important to take seriously the treatment, take preventive measures to avoid re-infection and exclude the possibility of chronic disease. Do not self-medicate, do not put yourself at risk. It is better to consult a doctor once again than to regret all life about lost health. Moreover, this disease is fraught with such consequences as visual impairment (hypermetropia, myopia, astigmatism), lesion of deeper tissues.

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