Intro To Eye Infections Flashcards by Brandon edlund

What is Keratitis?

Inflammation of the cornea

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What is Blepharitis?

Inflammation of the eyelid

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What is Keratoconjuntivitis?

Inflammation of the eye and cornea

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What is Uveitis?

Inflammation of the middle layer: iris, ciliary body, choroid

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What is Chorioretinitis?

Inflammation of the choroid and retinal layers

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What is Endophthalmitis?

Inflammation of the aqueous and vitreous humor

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What is the route of most eye infections?

Trauma
Paranasal sinus transfer
Anatomical abnormality
Fewer tear production

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What is chronic conjunctivitis and what is it associated with?

Inflammatory disease of the eyelid margin where too much oil is produced

Blepharitis

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What is a stye/Hordeolum?

Localized inflammation often on lower lid due to bacterial growth in eyelash

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What bacteria is associated with chronic conjunctivitis with Blepharitis?

Staphylococcus epidermidis

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What is the treatment of chronic conjunctivitis with Blepharitis?

Erythromycin ointment

Keep the eye clean

Warm and compress the gland

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What eye defense mechanisms do tears contain?

SlgA

Lysozyme

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How does blinking act as a defense mechanism against infection?

Inhibits microbial attachment

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How does the conjunctiva contribute to eye defense mechanisms?

Lymphocytes, plasma cells, neutrophils, and mast cells which produce antibodies and cytokines

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What is conjunctivitis caused by?

Dilation and congestion of subepithelial vessels

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What are some characteristics of conjunctivitis?

Discharge (clear or milky)
Irritation
Sensitivity to palpitation

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What is the most common viral cause of conjunctivitis?

Adenovirus

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What is the common cause of bilateral conjunctivitis?

Bacterial first, then viral

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What is the discharge from conjunctivitis from both bacterial and viral infections like?

Bacterial - mucopurulent

Viral - mild, watery, “sleepers”

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What conjunctivitis cause has association with ear infections?

Bacterial

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What is a key symptom of allergic conjunctivitis?

Itchy eyes

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What is the response of allergic rhinoconjunctivits?

IgE response by B-cells
IgE coats mast cells
Mast cells release histamine
Histamine causes inflammation

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What is the most common cause of neonatal viral conjunctivitis?

HSV

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What is symptomatic of viral conjunctivitis?

Watery

Previous infection

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What are some characteristics of adenoviruses?

``` Non-enveloped dsDNA Lytic on epithelium cells Latent is lymphoid cells Highly contagious through fomites in swimming pools ```

What is an example of adenovirus?

Coxsackie

What adenoviruses infect cells of the respiratory tract?

4 and 7

What adenoviruses are associated with conjunctivitis?

19 and 37

What adenoviruses are associated with enteric organ infections?

40, 41, and 42

How do you detect an adenovirus conjuntivitis?

AdenoPlus | Detects adenovirus hexon protein of the viral capsid

What are the top three bacterial causes of conjunctivitis?

Staph aureus H. Influenze Strep pneumoniae

What is the most common cause of adult conjunctivitis?

Staphylococcus aureus

What is the treatment options for bacterial conjunctivitis?

Polytrim (trimethoprim + polymixin) Moxifloxacin (fluoroquinolone drops)

What is the mechanism of action of Moxifloxacin and fluoroquinolone?

Topo II and IV inhibitors | Both gram + and -

What is the mechanism of action of trimethoprim?

inhibits dihydrofolatereductase selectively in bacteria Bacteria static

What is the mechanism of polymixin b and what is its spectrum?

Binds to LPS creating holes in the membran

What is the cause of hyperacute bacterial conjunctivitis?

Neisseria gonorrhoeae (meningidis less often)

What is a key symptom of a Neisseria conjunctivitis?

Copious amounts of yellow-green discharge (purulent) Preauricular adenopathy

How do you culture Nersseria gonorrhoaea?

Gram negative Intracellular diplococci Chocolate agar with vancomycin, colistin, nystatin, trimethoprim

How do you treat Neisseria gonorrhoeae?

Promptly with systemic ceftriaxone (broad) May augment with topical antibiotics Otherwise progression to corneal ulceration and perforation

What is ophthalmia neonatorum?

Conjunctivitis or Keratoconjuntivitis occurring within the first four weeks of birth

What causes ophthalmia neonatorum?

N. Gonorrhoeae, C. Trachomatis, Staph, Strep, | E. Coli, H. Influenzae, or H. Simplex

How do you prevent ophthalmia neonatorum?

Prophylactic erythromycin ointment | Culture and smear for diagnosis

How do macrolides like erythromycin and azithromycin?

Bind the 50S subunit (23s specifically) of RNA polymerase

How do you treat Chlamydia?

Macrolides like erythromycin and azithromycin | Systemic

Want are some adverse side effects of macrolides?

GI discomfort Hepatic failure Prolonged QT interval Inhibits cyt P450

What do stereotypes D-K of Chlamydia trachomatis cause?

Inclusion conjunctivitis

What do stereotypes A-C of Chlamydia trachomatis cause?

Trachoma

What is the leading cause of blindness world wide?

Trachoma By Chlamydia trachomatis since there is no long lasting immunity scarring the cornea further

How do you diagnosis Chlamydia trachomatis?

A fluorescent antibody

What do you see on a microscope with chlamydia trachomatis?

Intracellular basophils inclusion bodies

What is a common coinfection of chlamydia trachomatis?

N. Gonorrhoeae

How do you treat chlamydia trachomatis?

Systemic azithromycin Also treat sexual partners World wide prophylactic

What are the two different forms of chlamydia trachomatis?

Elementary body - enters the epithelial cells converts to... Reticulate bodies - which replicates using binary frisson

Which form of chlamydia trachomatis has a rigid outer membrane?

The elementary bodies that need protection from the extra cellular enviornment

How does HSV-1 Keratoconjuntivitis present?

Similar to adenovirsuses but more pain Rare you have a blue eyeball presentation with scarring

How do you treat HSV-1 Keratoconjuntivitis?

Systemic acyclovir If corneal involvement treat with topical trifluridine Consider prophylactic treatment with erythromycin to prevent bacterial superinfection

What is Trifluridine?

A pyrimidine analog Uses host kinases Used when acyclovir resistant

What are some symptoms of Keratitis?

More likely to have vision defects Photophobia Pain (lots of nerve endings) Foreign body sensation

What is viral keratitis caused by?

HSV-1 Adenovirus VZV

What are some bacterial causes of keratitis?

Staph, strep, pseudomonas

What increases your susceptibility for keratitis?

Trauma, drying of the epithelial Hypoxia

What are some other causes of keratitis?

Acanthamoeba | Fungal in warm environments

How do you treat bacterial and viral keratitis?

Bacterial - Moxifloxacin eye drops Viral - trifluridine and acyclovir

What are some characteristics of pseudomonas aeroginsoa?

Gram negative Aerobic rod Flagella Everywhere Oppertunistic Naturally resistant to many antibiotics and disinfectants due to ability to form biofilms

What is a virulence factor of pseudomonas that inhibits mitochondrial enzymes disrupting ciliary beating in keratitis?

The blue pigment pyocyanin

What virulence factors does pseudomonas have?

Adherence factors Cytotoxins like elastase and alkaline protease that destroy the corneal epithelium Host immune response leads to scarring

What are two form of parasites?

Cyst | Tropozoic (infection)

What are amoebas like and treated?

Yeast | Azoles

What are some causes of uveitis?

Herpes, zoster

What does toxoplasma usually cause?

Visual defects Chorioretinitis Congenital

What infectious organism for Chorioretinitis and really all other eye infection will you worry about in immunocompromized patients (HIV)?

Toxo and CMV

What parasitic worms should you worry about that cause Chorioretinitis (and blindness)?

Toxocara canis Onchocerra volvulus - river blindness Both transmitted through sand flies

What do you see with CMV retinitis?

Brush fire retina

What do you use to diagnosis toxo?

IgM serology

How do you treat toxoplasma?

Pyrimethahamine and sulfadiazine that inhibit production of pyrimidines also trimethoprim

What is Endophthalmitis and what are some common characteristics?

``` Inflam of the humors (blockage) Rare Pain, redness, decreased vision Bacteria and fungi Common after cataract surgery with Oppertunistic infection Blood spread ```

What is the common treatment for Endophthalmitis?

Fluoroquinolone or vancomycin injected into the eye

Intro To Eye Infections Flashcards

(78 cards)