Bacterial Conjunctivitis

Definition

It defines itself bacterial a type of bacterial-borne infectious conjunctivitis.

Normally, bacterial conjunctivitis is a self-limiting benign disease that can be resolved in a matter of days by topical application (directly into the eye) of antibiotics.

Together with the viral and allergic variant, bacterial conjunctivitis is one of the most common disorders of the eye; precisely, it is an infection that affects the conjunctiva, the thin protective film that covers the inner eyelid and the eyeball.
Although it is rather easy to eradicate, bacterial conjunctivitis should not be underestimated: it is in fact important to always carry out all the necessary investigations to ascertain that the infection has an actual bacterial origin and does not hide a systemic pathology.

Causes and risk factors

We have seen that bacterial conjunctivitis is an "extremely common infection: this type of" eye infection appears to make up roughly over half of all types of acute conjunctivitis.
In the adult, bacterial inflammation of the conjunctiva is more often sustained from Staphylococcus spp., Streptococcus pneumoniae, Haemophilus influenzae And Moraxella catarrhalis. In children, on the other hand, bacterial conjunctivitis is mainly caused by H. influenzae, S. pneumoniae And M. catarrhalis.
Some patients are more exposed to bacterial infections in general and infectious conjunctivitis in particular. Risk factors include:

Frequent contact with infected individuals
Use of contact lenses
AIDS (acquired immunodeficiency syndrome)
Sinusitis
Colds (major risk factor for viral conjunctivitis)
STDs (not surprisingly, even babies born to infected mothers can be affected by bacterial conjunctivitis immediately after birth).

Symptoms

All forms of conjunctivitis manifest themselves with common symptoms, such as hyperemia (redness of the eyes), abnormal tearing, photophobia and swollen eyelids: due to the non-specificity of the symptoms, it is often difficult to identify the precise type of conjunctivitis immediately.Nevertheless, some symptoms are peculiar and characteristic of an "infection of the conjunctiva; therefore, from the detailed analysis of the clinical picture, we can orient ourselves towards a precise variant of conjunctivitis.
Specifically, bacterial conjunctivitis is recognized by "observation of the lacrimal secretion: the typically infectious conjunctival secretion is abundant and purulent, and takes on a yellowish, sometimes greenish hue. Collecting in the conjunctival sac and partially overflowing, this secretion causes the typical" gluing effect " "to the eyelids, which struggle to open.
Unlike allergic conjunctivitis, the bacterial form does not manifest an intense itch and lacrimation is not particularly abundant.

Complications

When conjunctivitis is treated with the right drugs, fully respecting the dosage of the drugs, the prognosis is excellent.
Complications can occur when the disease spreads to the cornea, an eventuality that is not uncommon when bacterial conjunctivitis - especially when caused by chlamydia or gonorrhea - is not adequately treated.
In the context of bacterial conjunctivitis, mortality (however a remote event) is linked to the lack of recognition of the pathology, particularly in immunocompromised patients. Sepsis (or septicemia) and meningitis resulting from conjunctivitis sustained by N. gonorrhoeae they can in fact endanger the patient's life. In infants, untreated chlamydial conjunctivitis can lead to otitis media or pneumonia.

Diagnosis

A suspicion of bacterial conjunctivitis must be ascertained through specific investigative medical tests, which are also essential for differential diagnosis. It is in fact important to distinguish bacterial conjunctivitis from diseases that involve similar symptoms, such as: uveitis, glaucoma, keratitis, eye trauma, episcleritis (inflammation of the superficial layers of the sclera of the eye), viral conjunctivitis, allergic conjunctivitis, dry eye syndrome, cancer (ocular sebaceous carcinoma).
The diagnosis begins with the anamnesis, that is with the medical evaluation of the symptoms reported by the patient and his clinical history. Then, the doctor proceeds with the examination of the eyes, in which the degree of redness and swelling of the eyelids is assessed; here, a sample of conjunctival secretion is usually taken, and subsequently sent to the laboratory for a "cytological (cellular) investigation."

Treatment

The therapy for bacterial conjunctivitis makes use of eye drops and ophthalmic ointments to be applied directly into the eye. In general, broad spectrum antibiotics are prescribed, therefore active on more bacteria; when the germ is isolated, the doctor prescribes a specific type of eye drops. For example, to treat an "eye infection caused by Pseudomonas aeruginosa the most suitable eye drops are formulated with gentamicin; fusidic acid, on the other hand, is recommended for bacterial staphylococcal conjunctivitis.
Other drugs indicated to combat bacterial conjunctivitis are: Trimethoprim with polymyxin B, Tobramycin, Neomycin, Ciprofloxacin, Gatifloxacin and Erythromycin.
As a support to antibiotic therapy, doctors often recommend a complementary use of corticosteroid eye drops with an anti-inflammatory action, formulated for example with Cortisone, Triamcinolone, Dexamethasone and Hydrocortisone.
Specific eye drops are available on the market for bacterial conjunctivitis consisting of a mixture of active antibiotics and corticosteroids. For example, the specialty medicine Mixotone is an eye drop consisting of hydrocortisone (corticosteroid drug) and two antibiotics (neomycin and polymyxin B).

Prevention

Hygiene first of all: compliance with normal hygiene rules is essential to minimize the risk of any type of infection, including bacterial conjunctivitis. Strictly speaking, it is advisable to always wash your hands, especially before touching your eyes (a habit, the latter, which should be avoided as much as possible). is to avoid the mixed use of towels, sheets or other clothing: this is important to limit the risk of infection. It goes without saying that bacterial infections such as conjunctivitis can be prevented by avoiding contact with infected patients as much as possible.
Nursery children, students and workers (especially those who practice their profession in public settings) should stay at home for the duration of therapy or until bacterial conjunctivitis is no longer contagious.