Thygeson(1950) reported the specific type of superficial punctate keratitis and suspected this probably come from viral origin. Braley(1953) described and illustrated well about the superficial punctate keratitis in his article. According to his paper, its diagnostic features can be summarized as follows; 1) Appearance as a chronic, bilateral punctate epithelial keratitis. 2) Long duration. 3) Eventual healing without scar. 4) Lack of response to systemic or topical antibiotics or sulfonamide, or to removal of corneal epithelium. 5) Striking symptomatic response to topical steroids. These diagnostic features form the basis for this report. 249 cases of this disease has been observed during the period of this study(October, 1960-July, 1962). 25 cases were available for detailed clinical and laboratory analysis. Following observations were made. 1) Corneal punctate opacity is strictly epithelial and located mostly in lower quadrant in chronic cases without associated conjunctivitis. 2) None of the cases gave a history of acute onset. 3) Long duration with remission and exacerbation. 4) No response to topical antibiotics or sulfonamide, or to removal of corneal epithelium. Remarkable symptomatic response to topical steriod. 5) No seasonal and professional relationship with this disease. 6) Normal conjunctival bacterial flora in simple culture. None of them showed inclusion bodies or significant cytological changes. No lesions developed in rabbit cornea inoculartion using scraping from conjunctiva and cornea. 7) Healing without scar. 8) Further detailed virological studies are needed for determinning the etiological agent.
Anti-Bacterial Agents ; Cicatrix ; Conjunctiva ; Conjunctivitis ; Cornea ; Epithelium, Corneal ; Inclusion Bodies ; Keratitis* ; Seasons ; Steroids ; Strikes, Employee

INTRODUCTION: This study aimed to determine the in vitro susceptibility of standard isolates of common pathogens causing bacterial conjunctivitis to non-fluoroquinolone antimicrobial ophthalmic medications. METHODS: This is a single-blind experimental study which compared the in vitro susceptibility of Staphylococcus aureus, Streptococcus pneumoniae, Pseudomonas aeruginosa and Staphylococcus epidermidis to locally available non-fluoroquinolone ophthalmic medications, specifically chloramphenicol, tobramycin, fusidic acid, gentamicin sulfate, sulfacetamide and polymyxin-neomycin. Utilizing the disk diffusion method, zones of inhibition in millimeters for each bacterial isolate was recorded and tabulated. Kruskal-Wallis test was used to determine statistical differences. RESULTS: Both Staphylococci were sensitive to all antibiotics except sulfacetamide. Only chloramphenicol showed activity against all four isolates. Tobramycin showed the largest zone of inhibition against Pseudomonas aeruginosa. There was statistically significant difference in the median zone of inhibition in each antimicrobial medication against Staphylococcus aureus (p = 0.002) and Staphylococcus epidermidis (p < 0.001) with the largest mean zone of inhibition by fusidic acid of 34 and 38 millimeters, respectively. Streptococcus pneumoniae was least susceptible to antibiotics tested; only chloramphenicol and fusidic acid showed activity. There were also significant differences in the median zones of inhibition across the isolates. CONCLUSION The standard isolates are susceptible to at least one non-fluoroquinolone ophthalmic medication. The antibiotics tested showed differences in activity against the four isolates. The findings of this study may be used as a basis to review local practice patterns or/and initiate revisions in the guidelines for prescribing initial treatment of bacterial conjunctivitis.
Conjunctivitis, Bacterial ; Anti-Bacterial Agents

The fungal infection tends to increase more and more in general medical field and so does on the enphosis of ophthalmologic field. It is certain that it is responsible for abuse of steroid and various antibiotics of abundant administration. Authors wish to report collected cases of fungal conjunctivitis caused by Aspergillus species and Fusarium species which we have experienced and treated in our clinic at P.M.C.
Anti-Bacterial Agents ; Aspergillus ; Conjunctivitis ; Fusarium

PURPOSE: We investigated the causative microorganisms and the most effective antibiotics in conjunctivitis of infants according to the delivery methods, prophylactic antibiotics, epiphora and neonatal care places. METHODS: 51 consecutive infants aged less than 1 year-old, presented to the hospital from March 2001 to March 2003 with a sign of conjunctivitis, were examined. We analyzed ocular symptoms, symptom duration, delivery method, neonatal care places, and prophylactic antibiotics of the infants. Culture from the conjunctiva and conjunctival discharge, and antibiotic sensitivity test for the detection of microorganisms were done. RESULTS: Organisms were isolated from 37 (72.5%) of 51 patients. Common causative organisms were S. aureus (25.9%), S. pneumoniae (9.3%) and H. influenzae (9.5%). The most effective antibiotic for Gram(+) as well as Gram (-) bacteria was found to be ciprofloxacin in this study. Bacterial distribution showed no difference regardless of the symptoms, symptom duration, delivery method, neonatal care places, and prophylactic antibiotics in patients less than 6month-old (P>0.05). CONCLUSIONS: The ciprofloxacin was the most effective antibiotic against the causative organisms in infantile conjunctivitis.
Anti-Bacterial Agents ; Bacteria ; Bacteriology* ; Ciprofloxacin ; Conjunctiva ; Conjunctivitis ; Conjunctivitis, Bacterial* ; Humans ; Infant* ; Influenza, Human ; Lacrimal Apparatus Diseases ; Pneumonia

PURPOSE: To study the causative microorganism of neonatal bacterial conjunctivitis and its correlation with maternal factors. METHODS: We retrospectively reviewed the medical records of 55 neonates diagnosed with bacterial conjunctivitis and the records of mothers from January 2008 to July 2013. We investigated microbiologic culture of conjunctival discharge, time of occurrence, the mode of delivery, premature rupture of membrane (PROM), microbiologic culture of vaginal swab and the sensitivities to antibiotics. RESULTS: The most common organism was Staphylococcus epidermidis, isolated in 24 (36.4%) neonates, followed by other Coagulase-negative Staphylococcus (CNS) 10 (15.2%), E. cloacae 6 (9.1%), S. marsescens 6 (9.1%), and P. aeruginosa 5 (7.6%). Concerning the time of occurrence, 23 (41.8%) were founded with conjunctivitis within 1 week of life. By mode of delivery, 18 (32.7%) were delivered through vaginal route and 37 (67.3%) delivered by Cesarean section. The most common organism grown in conjunctival discharge of both group was S. epidermidis. Of these 55 neonates' mothers, 9 (16.4%) had history of PROM. Regardless of the presence of PROM, the most common organism was S. epidermidis. A total of 22 (40.0%) microbiologic culture of vaginal swab were examined and 6 (27.2%) of them had detected organisms. The results of vaginal swabs were in discord with results of conjunctival swabs of neonates. CONCLUSION: S. epidermidis was the most common infectious organism of neonatal bacterial conjunctivitis. We could not identify the correlation between neonatal bacterial conjunctivitis and maternal factors. Further comprehensive studies are needed to investigate the risk factors related to bacterial conjunctivitis of neonates.
Anti-Bacterial Agents ; Cesarean Section ; Cloaca ; Conjunctivitis ; Conjunctivitis, Bacterial* ; Female ; Humans ; Infant, Newborn ; Medical Records ; Membranes ; Mothers ; Pregnancy ; Retrospective Studies ; Risk Factors ; Rupture ; Staphylococcus ; Staphylococcus epidermidis

PURPOSE: In the Spring 1995, there was an outbreak of adenoviral infection, which caused four death out of ten patients with adenoviral pneumonia in our hospital. Clinical courses of ten patients with severe pneumonia were similar each other, and two were confirmed as adenoviral pneumonia by postmortem autopsy. Although not proven, we believe eight patients had adenoviral pneumonia. Therefore, we report clinical features in ten cases of severe adenoviral pneumonia. METHODS: Two cases with adenoviral pneumonia and eight cases with presumed adenoviral pneumonia were admitted in this hospital from March to June, 1995. Age and sex distribution, clinical manifestations, laboratory data, chest X-ray findings were reviewed. RESULTS: They were young children between 4 to 25 months of age(mean 12.7+/-6.1 months), and male to female ratio was 9:1. They presented with abrupt fever, cough, tachypnea, and dyspnea. Mean duration of fever were 12.7+/-6.1 days. Crackles on auscultation were heard in all patients. Studies for Mycoplasma and Tuberculosis were all negative. Cultures of bacteria and fungi were negative, and they did not respond to the antibiotics. The chest X-ray revealed the diffuse lobar consolidation with varying amount of pleural effusions. The findings of pleural fluid showed characteristics of transudate with predominant monocyte. Eight of our severe adenoviral pneumonia patients were enjoying normal health previously. Only two patients had previous medical problems, one with chronic cytomegalovirus pneumonia and the other with neutropenia induced by phenobarbital. The course of illness suggests that the infection was hospital acquired and the final outcome was fatal. Three of them developed seizure with fever, five change of consciousness, four conjunctivitis, three otitis media, and two gastro-intestinal symptoms. Autopsy was done in two of four patients. Grossly, the lungs were heavy and dark- red in color. There were bilateral pneumonic consolidation with patchy areas of hemorrhage. Microscopically, severe necrotizing bronchitis and bronchiolitis with numerous intranuclear inclusion of Cowdry type A and B were found. Alveoli were edematous and filled with fibrinous exudate, and covered with hyaline membrane. Ultrastructurally, typical adenoviral particles showing hexagonal shape in paracrystalline array symmetry were found in the nucleus of aleveolar lining cells. CONCLUSIONS: Yet, occasionally, adenoviral infection becomes most aggressive form of pneumonia. We should consider adenoviral pneumonia when clinical findings of pneumonia are very similar with baterial pneumonia except poor response to broad spectrum antibiotics. There is no specific treatment for adenoviral infection. So, for prevention of adenoviral pneumonia, we recommend isolation in suspicious adenoviral infection.
Adenoviridae ; Anti-Bacterial Agents ; Auscultation ; Autopsy ; Bacteria ; Bronchiolitis ; Bronchitis ; Child ; Conjunctivitis ; Consciousness ; Cough ; Cytomegalovirus ; Dyspnea ; Exudates and Transudates ; Female ; Fever ; Fibrin ; Fungi ; Hemorrhage ; Humans ; Hyalin ; Intranuclear Inclusion Bodies ; Lung ; Male ; Membranes ; Monocytes ; Mycoplasma ; Neutropenia ; Otitis Media ; Phenobarbital ; Pleural Effusion ; Pneumonia* ; Respiratory Sounds ; Seizures ; Sex Distribution ; Tachypnea ; Thorax ; Tuberculosis

Sebaceous carcinoma of the eyelid is a rare tumor that usually arises from tarsal sebaceous gland. Because the clinical manifestations can masquerade as unilateral recurrent chalasion or chronic blepharoconjunctivitis, its diagnosis may be delayed. Therefore, early biopsy for diagnosis is needed for the persistently recurring unilateral blepharoconjunctivitis. The masquerade syndrome was first described in 1967 by Theodore and Irvine as chronic blepharoconjunctivitis due to an underlying conjunctival carcinoma. While the originally described neoplasms were squamous cell carcinomas, many of the tumors producing this clinical picture are believed to be sebaceous in origin. We experienced a case of pathologically confirmed sebaceous carcinoma of the eyelid which originally masqueraded as chronic blepharoconjunctivitis and was treated with topical antibiotics and steroids for 1 year and 8 months, finally being treated by partial orbital exenteration.
Anti-Bacterial Agents ; Biopsy ; Carcinoma, Squamous Cell ; Conjunctivitis* ; Diagnosis ; Eyelids ; Orbit ; Sebaceous Glands ; Steroids

Gardnerella vaginalis is a normal component of the vaginal flora and is one of the organisms associated with bacterial vaginosis. It is rarely involved in neonatal infection. Although it is possible that G. vaginalis plays an etiologic role in bacteremia, facial cellulitis and abscess, conjunctivitis, infected cephalhematoma, scalp abscess, respiratory disease and meningitis in newborns, G. vaginalis is an uncommon pathogen of neonatal sepsis and meningitis. We report a 3,830 g term neonate with sepsis and meningitis due to G. vaginalis and review the characteristics of neonatal G. vaginalis infection reported in the literatures.
Abscess ; Bacteremia ; Cellulitis ; Conjunctivitis ; Gardnerella vaginalis* ; Gardnerella* ; Humans ; Infant, Newborn ; Meningitis* ; Scalp ; Sepsis* ; Vaginosis, Bacterial

We shall devide the specific types of conjunctivitis into four main categories: (1) infectious conditions, (2) allergic conditions, (3) irritative conditions, and (4) inflammations occuring in association with diseases of the skin and mucous membranes. Bacterial conjunctivitis is the most common types of infections conjunctivitis. The common causes of bacterial conjunctivitis are Moraxella, Hemophillus, Staphylococcus, Streptococcus, Pneumococcus, Gonococcus, Corynebacterium diphtheriae. The genus citrobacter is closely related to the Salmonella-Arizona group of Entrobacteriaceae. They are usually recovered as commensals or as secondary pathogens from patients with altered host defences. The most commonly involved sites are the urinary and respiratory tracts. A 6 month old Korean male was found to hyperacute conjunctivitis OU which had developed for about 15days. Citrobacter freundii was recovered from the conjunctival exudate through smear, culture and biochemical study. Beside his conjunctivitis OU, this child was physically healthy and not found to have immunodeficiency. The conjunctivitis was treated and recovered with topical 0.5% Gentamycin and amoxycyillin 400mg.
Child ; Citrobacter freundii* ; Citrobacter* ; Conjunctivitis* ; Conjunctivitis, Bacterial ; Corynebacterium diphtheriae ; Exudates and Transudates ; Gentamicins ; Humans ; Infant ; Inflammation ; Male ; Moraxella ; Mucous Membrane ; Neisseria gonorrhoeae ; Respiratory System ; Skin ; Staphylococcus ; Streptococcus ; Streptococcus pneumoniae

Gonococcal conjunctivitis is rare in adults and, if not treated properly, can cause corneal perforation. Gonococcal conjunctivitis typically presents with a severe mucopurulent discharge, similar to that associated with viral conjunctivitis. Here, we describe a case of monocular gonococcal conjunctivitis, including its clinical characteristics and slit-lamp images, which was initially misdiagnosed as epidemic conjunctivitis. A 20-year-old man was referred to our hospital with no improvement in monocular infection and purulent ocular discharge after 2-wk treatment using antibiotic and 0.1% fluorometholone eye drops at the local ophthalmic clinic. Initially, 0.5% loteprednol eye drops were used since we suspected viral conjunctivitis. Following this treatment, conjunctival infection worsened and a yellow-white ocular discharge covered the conjunctiva and cornea surface. Additional history taking revealed that the patient had sexual contact with a prostitute 1 wk prior to symptom presentation and, after the encounter, he took antibiotics for genital discharge at the local urology clinic, but self-discontinued treatment. A Gram staining showed gram-negative diplococci and culture of collected ocular discharge from the palpebral conjunctiva revealed growth of Neisseria gonorrhoeae, confirming gonococcal conjunctivitis. Following this, the patient was systemically treated with 3rd generation cephalosporin antibiotics. After 3-d treatment, conjunctival infection and purulent ocular discharge had significantly improved. When clinical symptoms are aggravated following steroid eye drop treatment for suspected monocular viral conjunctivitis, gonococcal conjunctivitis must be considered as a differential diagnosis
Adult* ; Anti-Bacterial Agents ; Cephalosporins ; Conjunctiva ; Conjunctivitis* ; Conjunctivitis, Viral ; Cornea ; Corneal Perforation ; Diagnosis, Differential ; Fluorometholone ; Humans ; Loteprednol Etabonate ; Male* ; Neisseria gonorrhoeae ; Ophthalmic Solutions ; Sex Workers ; Urology ; Young Adult