Infections Flashcards
Young female teen presents with a bilateral conjuctivitis and burning when she pees. She recently engaged in uprotected sex. What investigation should you run? What is the likely diagnosis? treatment?
Swab and culture of the eye
Chlamydial conjunctivitis
Topical oxytetracycline
Man presents with sore, red eyes, he says in the morning they are stuck together with some kind of glue thing. Likely diagnosis? Treatment?
Bacterial conjunctivitis
Self limiting but could give eye drops of chloramphenicol 2-3 hourly
What are the likely organisms that cause bacterial conjunctiviitis in adults?
Staph aureus, strep pneumoniae, hameophilus influenzae (but more likley in kids)
Usual contact lens user presents with pain in his right eye it came on all of a sudden. He mentions its painful to look at bright lights and his vision is quite blurred in that eye. On examination there is a white spot on the cornea and his sclera is red. What is the investigation and likely diagnosis?
Bacterial keratitis (corneal infection)
Corneal scrape give them first some local anaesthetic then lift some of the tissue
What is the treatment for bacterial keratitis?
Admit them to hospital for eye drops ever hour for 48 hours
Once determined organism give ofloxacin for corneal ulcers OR gentamicin and cefuroxime for gram positive/ negative organsims
Man presents with an extremely painful eye to the point he cannot open it. You give some local anaesthetic to open it and see red vessels that look like a branching tree/ dendrite. What is the likely diagnosis and treatment?
Viral keratitis from the herpes simplex virus
Treat with antiviral aciclovir 3% and admit to hospital
You diagnose viral keratitis due to the herpes simplex virus. What is the treatment?
A. Hydrocortisone ointment
B. Aciclovir 3%
C. Chloramphenicol
D. Flucloxacillin
B is correct
NEVER give steroids as this will cause corneal melt and perforation
C. Is used for bacterial conjunctivitis- it is an atibiotic against strep and haemophilus
D. Antibiotic against staph aureus
Man presents with a red watery eye, with bits floating around his vision. On examination it appears there are white fluffy bits in the cornea. He is recovering from a respiratory infection. What is the diagnosis? Treatmetn?
Adenoviral keratitis
Self limiting
Man who washes his contact lens in tap water acquires fungal keratitis in one eye. What is the likely organism?
Acanthamoeba
Child presents painful eye especially when moving it they are also pyrexial. On examination they have proptosis, a red circle around the orbit confined to the eye zone including the upper lid. They can follow your finger but its painful. What is the likely investigation, diagnosis and treatment?
Orbital cellulitis
CT scan of the head to check for compartment syndrome
Surgical drainage of the pus
What are some of the usual organisms that can cause orbital cellulitis?
Staphylococci Streptococci Coliforms Haemophilus influenzae Anaerobes
What is the organisms that causes endopthalmitis
Staph epidermidis, usually commensals
Man post eye surgery presents with a red sclera, extremely painful eye with decreasing vision. He is now unable to open his eye due to pain. What is the likely diagnosis?
Endophthalmitis
From eye commensals like staph epidermidis
Patient with recently diagnosed AIDS presents with a painful eye. You have a look at his eye with the opthalmascope and see multiple red patches especially around the optic disc. What is the likley diagnosis?
Chorioretinitis
Man presents with growing mass on the medial side of his eye between his inner eye and his nose. It has been growing in size and is now obstructing his vision. What is the diagnosis? And treatment?
Dacrocystitis
Blockage of the lacrimal sac that then becomes infected
Surgical drainage
