pseudomembranous conjunctivitis

Pseudomembranous conjunctivitis can manifest in various ways, making it essential to be aware of the common signs and symptoms.

Common Signs and Symptoms:

• Thin membrane formation: A thin, yellowish sheet of fibrin and inflammatory debris forms on the palpebral conjunctiva [1].
• Eye redness and swelling: The affected eye may appear red, swollen, and inflamed [7].
• Discharge: A mucopurulent discharge is often present, which can be watery or thick in consistency [4].
• Pseudomembrane formation: A pseudomembrane, a thin membrane of fibrin and inflammatory debris, forms on the surface of the eye [1].
• Conjunctival injection: The conjunctiva may appear injected or inflamed, which can be accompanied by tearing and redness [7].

Additional Symptoms:

• Fever and malaise: Some cases may present with fever, malaise, fatigue, and enlarged lymph nodes [9].
• Preauricular lymphadenopathy: Lymph node swelling in the preauricular area (in front of the ear) can occur [6].

It's essential to note that pseudomembranous conjunctivitis can be a symptom of various underlying conditions, including viral or bacterial infections. If you suspect you have this condition, it's crucial to consult with an eye care professional for proper diagnosis and treatment.

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Pseudomembranous conjunctivitis can be diagnosed through various diagnostic tests, which are essential for proper management and treatment.

• Removal of membranes and pathologic examination: This is a crucial step in diagnosing pseudomembranous conjunctivitis. The removal of the membrane and subsequent histopathological examination can help confirm the presence of the condition (1).
• Viral culture and PCR tests: Since viral infections, particularly adenoviruses, are a common cause of pseudomembranous conjunctivitis, viral culture and PCR tests can be used to identify the causative agent (3, 9). These tests can help determine the specific type of virus responsible for the infection.
• Gram stain and cultures: In some cases, bacterial infections may be suspected. Gram staining and culturing on chocolate and blood agar can be performed to identify any bacterial growth (7).
• Nucleic acid amplification tests (NAAT): NAATs are rapid, office-based immunodiagnostic tests that can be useful in diagnosing pseudomembranous conjunctivitis, especially when the inflammation is severe (9).

It's essential to note that a combination of these diagnostic tests may be necessary to accurately diagnose pseudomembranous conjunctivitis. A thorough clinical evaluation and examination are also crucial in making an accurate diagnosis.

References: 1. [1] Pseudomembranous conjunctivitis is an inflammatory condition of the conjunctiva characterised by conjunctival injection, mucopurulent discharge and ... 3. Viral Conjunctivitis. Adenoviruses are the cause of most (65–90%) cases of viral conjunctivitis, while the herpes simplex virus (HSV) is the cause of 1.3–4.8% of all cases of acute conjunctivitis. 7. by BH Feldman · Cited by 2 — A rapid antigen test for adenovirus is available for in-office use. Gram stain & Cultures in Chocolate and blood agar: Primarily used in cases ... 9. Nucleic acid amplification tests (NAAT) and other rapid, office-based immunodiagnostic tests, can be useful especially when the inflammation is severe and other ...

Treatment Options for Pseudomembranous Conjunctivitis

Pseudomembranous conjunctivitis can be treated with a combination of medications and removal of the pseudomembrane. The mainstay of treatment is to remove the pseudomembrane and treat the underlying cause, which includes antimicrobial cover of oft-presumed infective causes [1].

Antimicrobial Medications

Topical antibiotic therapy is often prescribed to treat bacterial conjunctivitis, a common cause of pseudomembranous conjunctivitis [4]. A combination antibiotic-steroid eye drop may be used to reduce inflammation and prevent infection [5]. Third-generation cephalosporins are also effective in treating this condition [14].

Steroids

Topical steroids may be used to reduce inflammation and prevent scarring, especially if subepithelial infiltrates impair vision [6]. However, it's essential to note that subepithelial infiltrates may recur even with steroid treatment.

Other Medications

Artificial tears and compresses are often prescribed to provide relief from symptoms such as blurred vision, eye swelling, and discharge [3][13].

Important Consideration

It's crucial to address the underlying systemic disease when treating pseudomembranous conjunctivitis. This may involve treatment with medications other than those specifically targeting the eye.

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Differential Diagnosis of Pseudomembranous Conjunctivitis

Pseudomembranous conjunctivitis is a condition characterized by the formation of a thin membrane on the surface of the eye, accompanied by symptoms such as blurred vision, eye swelling, and discharge. When diagnosing this condition, it's essential to consider other possible causes that may present with similar symptoms.

Possible Differential Diagnoses:

• Bacterial Conjunctivitis: This type of conjunctivitis is caused by bacteria such as Streptococcus, Staphylococcus aureus, Neisseria gonorrhea, and Corynebacterium diphtheriae. [9][10]
• Viral Conjunctivitis: Viral conjunctivitis can be caused by various viruses, including adenovirus, herpes simplex virus (HSV), Epstein-Barr virus (EBV), and varicella-zoster virus (VZV). [4][5][10]
• Chlamydial Trachoma: This is a bacterial infection that can cause conjunctivitis and is often associated with chronic inflammation. [3][10]
• Acute Viral Conjunctivitis: This type of conjunctivitis is caused by viruses such as adenovirus, HSV, and VZV. [14][15]
• Blepharoconjunctivitis: This condition involves inflammation of the eyelids and conjunctiva. [14]

Other Conditions to Consider:

• Kawasaki Disease: This is a rare condition that can cause conjunctival redness and swelling, among other symptoms. [15]
• Stevens-Johnson Syndrome: This is a severe skin and mucous membrane disorder that can cause conjunctival inflammation. [15]
• Carotid Cavernous Fistula: This is a rare vascular condition that can cause conjunctival redness and swelling, among other symptoms. [15]

Importance of Accurate Diagnosis

Accurate diagnosis of pseudomembranous conjunctivitis is crucial to ensure proper treatment and prevent complications. A thorough examination and consideration of differential diagnoses are essential in determining the underlying cause of the condition.

References:

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