Eye
Conjunctiva
Conjunctivitis
Infectious conjunctivitis
Author: Deepali Jain, M.D.
Last author update: 1 October 2014
Last staff update: 24 December 2020
Copyright: 2004-2023, PathologyOutlines.com, Inc.
PubMed Search: Infectious conjunctivitis [title]
Table of Contents
Definition / general | Epidemiology | Sites | Etiology | Clinical features | Case reports | Clinical images | Microscopic (histologic) description | Additional referencesCite this page: Jain D. Infectious conjunctivitis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/eyeconjinfectious.html. Accessed September 28th, 2023.
Definition / general
- See also Granulomatous conjunctivitis, Trachoma, Infectious keratitis
- Often due to inadequate personnel hygiene
Epidemiology
- In children, bacterial conjunctivitis is more common than viral
- Viral conjunctivitis is highly contagious
Sites
- Bulbar and palpebral conjunctiva
Etiology
- Most bacterial conjunctivitis is acute; chronic bacterial conjunctivitis is often caused by Chlamydia, rarely by Moraxella
- Adenovirus conjunctivitis:
- Most common cause of viral conjunctivitis (Arch Soc Esp Oftalmol 2013;88:108)
- 60% of ER conjunctivitis patients in Florida
- Detected by PCR (Optometry 2007;78:236)
- Other viruses:
- Herpes simplex virus
- Varicella zoster virus
- Enterovirus 70
- Coxsackie A24
- Molluscum contagiosum
- Vaccinia
- Human immunodeficiency virus
- Alcaligenes xylosoxidans conjunctivitis:
- Rare; can cause chronic conjunctivitis (Cornea 2007;26:868)
- Conjunctivitis within first 4 weeks of life
- Usually S. aureus, S. epidermidis, S .pneumoniae, M. catarrhalis
- Also C. trachomatis, N. gonorrhoeae, herpes simplex virus (HSV)
- Mothers with untreated chlamydial infections have a 30% to 40% chance of transmission to newborns
- Unilateral or bilateral (Pediatr Rev 2010;31:196)
- Bacterial conjunctivitis in children:
- Should exclude infected children from school until asymptomatic (J Pediatr Ophthalmol Strabismus 2007;44:101)
- Local antibiotics may not be necessary (Prescrire Int 2007;16:120)
- Often due to H. influenzae (Ophthalmology 2008;115:51) and Streptococcus pneumoniae
- S. aureus is uncommon in children (Acad Emerg Med 2007;14:1)
- Bacterial conjunctivitis in adults:
- Often due to Staphylococcus aureus, may be methicillin resistant
- Streptococcus pneumoniae is associated with outbreaks (Pediatr Infect Dis J 2006;25:906)
- Delayed use of antibiotics may be appropriate (BMJ 2006;333:321)
- Hyperacute conjunctivitis:
- Rapid onset
- Due to Neisseria gonorrhoeae or N. meningitides (Pediatr Rev 2010;31:196)
- Other bacteria are Pneumococcus species, Pseudomonas (Infection 2012;40:579)
- Gonococcal conjunctivitis:
- Due to autoinoculation
- Rare in developed countries (J Fr Ophtalmol 2007;30:e18)
- May cause corneal perforation (Med J Malaysia 2006;61:366)
- Influenza A virus conjunctivitis:
- Outbreak from poultry (Proc Natl Acad Sci U S A 2004;101:1356)
Clinical features
- Bacterial: itching, tearing, redness, purulent discharge, matting of eyelids
- Viral: irritation, photophobia, watery discharge
Case reports
- Child with acute conjunctivitis caused by Ewingella americana (J Pediatr Ophthalmol Strabismus 2012;49)
- 23 year old woman with conjunctivitis due to Achromobacter xylosoxidans (Arq Bras Oftalmol 2009;72:261)
Clinical images
Images hosted on other servers:
Adenovirus: various images
Gonococcal
Molluscum contagiosum
Trachoma with follicles
Trachoma with intense inflammation
Microscopic (histologic) description
- Neutrophils on Gram stain if bacterial; lymphocytes in viral conjunctivitis
